Concurrent Nasal Symptoms in Non-Rhinogenic Headache

This study aims to characterize concurrent nasal symptoms in a cohort of patients with non-rhinogenic headache (NRH) presenting to an otolaryngology clinic.

A prospective cohort.

Single tertiary care institution.

Adults with NRH were recruited over a 2-year period (February 2021 to February 2023). Patients were eligible if they endorsed midfacial pain or pressure for at least 10 days a month over the previous 3 months and had no evidence of rhinosinusitis on both nasal endoscopy and computed tomography imaging. Study participants used a mobile application to keep a daily log of their facial pain/pressure, nasal congestion, and nasal mucus/discharge. Symptom severity was scored on a scale from 1 (none) to 10 (worst) for 30 consecutive days. Repeated measures correlation coefficients were calculated to evaluate overall or common intra-individual association for each symptom.

Twenty-eight patients were enrolled, and they completed the 30-day symptom log. Median (range) scores were 5 (1-10), 4 (1-10), and 2 (1-10) for facial pain/pressure, congestion, and mucus, respectively. Patients had significant day-to-day fluctuations in scores for all 3 symptoms, with a significant positive correlation between symptoms: congestion/mucus (r = 0.74181, P < .0001), congestion/facial pain (r = 0.5873, P = .001), and mucus/facial pain (r = 0.49384, P = .0076).

Patients with NRH often have concurrent nasal symptoms. Moreover, nasal congestion, mucus, and facial pain/pressure had significant correlations in day-to-day fluctuations in severity. Our findings suggest the possibility that all three symptoms share a common pathophysiology.