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Headache or Facial Pain/Pressure in Rhinosinusitis: Subtle Clinical Patterns.
Takaki Inui1, Kou Moriyama1, Naohiro Takeichi1
1Department of Otorhinolaryngology-Head & Neck Surgery, Osaka Medical and Pharmaceutical University, Takatsuki, Japan.
The Laryngoscope
|May 21, 2026
Summary
Headache or facial pain is common in rhinosinusitis patients but usually mild. Systematic assessment, including endoscopy and imaging, is crucial for accurate diagnosis and management of sinonasal inflammation-related symptoms.
Area of Science:
- Otolaryngology
- Rhinology
- Pain Medicine
Background:
- Headache and facial pain are common symptoms in patients with rhinosinusitis.
- The prevalence and characteristics of these symptoms in otolaryngology practice require further elucidation.
Purpose of the Study:
- To determine the prevalence and clinical features of headache or facial pain/pressure in patients presenting with rhinosinusitis.
- To identify clinical factors associated with these symptoms.
Main Methods:
- Retrospective review of 304 patients with rhinosinusitis.
- Assessment of headache/facial pain in 202 patients, analyzed with symptom severity, CT scans, and endoscopic findings.
- Multivariable analysis to identify associated factors.
Main Results:
- 42.1% of patients reported headache or facial pain related to sinonasal inflammation.
- High-intensity pain and active migraine were rare.
- Middle meatal polyps were associated with lower odds of headache/facial pain (OR: 0.41).
Conclusions:
- Headache or facial pain/pressure is frequent but generally mild in rhinosinusitis patients seen in otolaryngology.
- Variability in symptom assessment underscores the need for systematic evaluation alongside endoscopic and radiologic data.
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