Diagnosis and treatment of rhinogenic headache

  Headaches caused by nasal and sinus lesions are collectively referred to as rhinogenic headaches. Clinical investigation shows that rhinogenic headache accounts for about 10-20% of all headache incidence. The sensory nerves of the nasal cavity and sinuses come from the trigeminal nerve. Nasal lesions can directly stimulate the trigeminal nerve endings in the nasal mucosa to cause headache, and can be reflected to other parts of the head along its branches. The characteristics of rhinogenic headache are: most patients have different degrees of nasal symptoms, such as nasal congestion, pus, olfactory changes and facial discomfort, which are mild or severe, intermittent or persistent, and are relieved when the inflammation is reduced or the inflammatory material in the sinus is discharged; the headache is mostly deep; the headache can be significantly reduced after using nasal mucosal astringent or intranasal spray of hormonal drugs; the headache attacks mostly have specific areas (more The common areas are forehead, between the eyebrows, top of the head, and head-occipital area), and there may be specific time headache attacks.  The diagnosis of rhinogenic headache usually requires clinical examination by an ENT specialist and, if necessary, a coronal CT examination of the sinuses.  The treatment of rhinogenic headache is based on the clinical and CT findings, and the cause of the headache is determined and treated accordingly.