Sinus headaches
Sinus headaches occur over the forehead and usually are accompanied by pain over the face, ears or teeth. Confirmation of rhinosinusitis clinically, endoscopically or on imaging (CT or MRI) is important for the diagnosis. Symptoms that suggest acute sinusitis include: nasal obstruction, loss of smell and yellow or green nasal discharge. The relationship between the headache and the rhinosinusitis is important since the should develop simultaneously and the headache resolve within a week of the resolution of the rhinosinusitis.
The pain associated with sinus headaches is deep, aching, and usually nonpulsatile. The location of pain varies depending on the sinus involved. With the frontal sinus the pain is over the forehead and top of the head with associated discomfort behind the eyes. With maxillary sinus the pain is adjacent to the nose and upper teeth. With the ethmoid sinus the pain is adjacent to the nose and behind the eyes and radiates to the temples. With the sphenoid sinus the pain is over the top and back of the head with associated discomfort over the forehead and behind the eyes.
Sinus headache treatment and pain relief
Treatment of acute sinusitis involves commencing antibiotics and decongestants. Pain relief and ensuring good fluid intake is important. In patients who do not respond to medical therapy then endoscopic sinus surgery should be considered.
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