Headaches and disease of the nose and paranasal sinuses

Headaches resulting from disease of the nose or paranasal sinuses are usually associated with symptoms (congestion, fullness, discharge, obstruction) that point to the site of origin. Occasionally, however, nasal or sinus disease can be manifested solely as headache. In that circumstance, office nasal endoscopy in combination with a computed tomography (CT) scan of the sinuses may demonstrate an abnormality or disease of the nose or paranasal sinus. Recent studies have demonstrated that a neuropeptide (substance P) is likely to be a mediator of pain arising in the nose or paranasal sinuses.