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Development of the Sinus Headache Screener (SHS)
David W Jang1, Hui-Jie Lee2, Ralph Abi Hachem1
1Department of Head and Neck Surgery & Communication Sciences, Duke University, Durham, North Carolina, USA.
The Laryngoscope
|June 24, 2026
Summary
The Sinus Headache Screener (SHS) accurately distinguishes non-rhinogenic facial pain from chronic rhinosinusitis. This tool aids in correct diagnosis, improving patient care and reducing unnecessary treatments.
Area of Science:
- Otolaryngology
- Rhinology
- Diagnostic Tools
Background:
- Facial pain is often misdiagnosed as sinusitis, leading to incorrect antibiotic or surgical treatments.
- Differentiating non-rhinogenic facial pain or pressure (NRFP) from chronic rhinosinusitis (CRS) is clinically significant.
Purpose of the Study:
- To develop and validate the Sinus Headache Screener (SHS), a brief questionnaire.
- To differentiate CRS from NRFP in patients presenting with facial pain or pressure.
Main Methods:
- A 89-item questionnaire bank was administered to 251 patients diagnosed with CRS or NRFP via imaging.
- Psychometric analysis and logistic regression identified 8 key items for the SHS.
- Predictive performance was assessed using receiver operating characteristic curve (AUC) analysis.
Main Results:
- The SHS includes 8 items with scores ranging from -4 to 9; higher scores indicate NRFP.
- With a cutoff score >0, the SHS demonstrated a sensitivity of 0.87 and specificity of 0.64 for NRFP.
- The optimism-corrected AUC was 0.798, indicating good discriminative ability.
Conclusions:
- The SHS effectively differentiates NRFP from CRS in patients with sinus headache symptoms.
- Implementing the SHS as a point-of-care tool can enhance diagnostic accuracy.
- This tool supports cost-effective management by guiding appropriate treatment decisions.
