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Rhinogenic Headache in Children and Adolescents
Gregory L Barinsky1, Curtis Hanba2, Peter F Svider3
1Department of Otolaryngology - Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA.
Insights
Pediatric patients often receive incorrect sinus headache diagnoses, with many actually having primary headache disorders. Rhinogenic headache and its surgical treatment in children require further research due to limited evidence.
Area of Science:
- Pediatric Neurology
- Otolaryngology
- Headache Medicine
Background:
- Rhinogenic headache is a complex condition in children.
- Misdiagnosis is common, often confused with primary headache disorders.
Purpose of the Study:
- To review and explain the current understanding of rhinogenic headache in pediatric patients.
- To explore the reasons for misdiagnosis and potential treatments.
Main Methods:
- Literature review of studies on pediatric rhinogenic headache.
- Analysis of diagnostic criteria and treatment outcomes.
Main Results:
- 40% of pediatric migraine patients were misdiagnosed with sinus headache.
- Over 50% of pediatric migraine patients exhibit cranial autonomic symptoms.
- Surgical treatment for rhinogenic contact point headache shows promise but lacks robust evidence.
Conclusions:
- Primary headache disorders are frequently overlooked in pediatric patients with rhinologic symptoms.
- Further high-quality trials are needed to validate surgical interventions for rhinogenic contact point headaches in children.
Purpose Of Review:
The purpose of this review is to evaluate and explain our current understanding of rhinogenic headache in the pediatric population.
Recent Findings:
One study showed that 40 % of pediatric patients with migraine had previously received an incorrect diagnosis of sinus headache. Two studies found that over 50% of pediatric patients with migraines have associated cranial autonomic symptoms, possibly elucidating the reasons for misdiagnosis. Some case reports demonstrate successful treatment of rhinogenic contact point headache with the surgical resection of mucosal contact points, although this diagnosis continues to be debated. Many pediatric patients diagnosed with a sinus-related headache actually meet criteria for primary headache disorders. Primary headache disorders should be considered in pediatric patients with headache and associated rhinologic symptoms. Some literature suggests that mucosal contact point headaches can be surgically treated in children, but the level of evidence is inadequate, and additional robust trials are needed.
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