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Rhinogenic and nonrhinogenic headaches.
1aDepartment of Otolaryngology, University of Malta, Msida, Republic of Malta bDepartment of Otorhinolaryngology, Nottingham University Hospital, Nottingham, UK.
Current Opinion in Otolaryngology & Head and Neck Surgery
|December 17, 2014
Summary
Chronic facial pain is often misattributed to sinusitis. Emerging evidence suggests non-sinus related causes are more common, requiring awareness among ear, nose, and throat specialists.
Area of Science:
- Otolaryngology
- Neurology
- Pain Management
Background:
- Facial pain is a frequent complaint in ear, nose, and throat (ENT) clinics.
- Historically, sinusitis has been a common presumed cause of facial pain due to anatomical proximity.
- Recent literature offers an evidence-based approach to understanding facial pain.
Purpose of the Study:
- To review current knowledge on the etiology, characteristics, progression, and management of chronic and recurrent facial pain and headaches.
- To differentiate between rhinogenic and non-rhinogenic facial pain.
- To contextualize facial pain within rhinosinusitis.
Main Methods:
- Review of recent publications in otolaryngology and neurology.
- Analysis of evidence differentiating rhinogenic and non-rhinogenic facial pain.
- Examination of surgical series and diagnostic imaging findings.
Main Results:
- Only 16-20% of sinusitis patients report facial pain, even with confirmed sinusitis.
- Up to 40% of patients experience persistent facial pain post-sinus surgery.
- Rhinogenic pain is typically unilateral, severe, and associated with endoscopic/CT abnormalities, but incidental findings are common.
Conclusions:
- The commonest cause of chronic facial pain is increasingly recognized as non-rhinogenic.
- Otorhinolaryngologists must be aware of diverse etiologies for facial pain.
- Distinguishing between rhinogenic and non-rhinogenic origins is crucial for effective management.
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