Ból zatokowy – Epidemiologia

Ból zatokowy
Epidemiologia

Ból zatokowy, często zgłaszany w praktyce klinicznej, jest w rzeczywistości rzadkim schorzeniem, a większość przypadków błędnie diagnozowanych jako ból zatokowy to migrena lub inne pierwotne bóle głowy. Epidemiologiczne dane wskazują, że prawdziwy ból zatokowy występuje u około 13% pacjentów z przewlekłym zapaleniem zatok, a barosinusitis notuje 3-4 epizody na 100 000 ekspozycji. Migrena, dotykająca około 14% populacji globalnie (20% kobiet, 6% mężczyzn), jest najczęstszą przyczyną błędnej diagnozy bólu zatokowego, z 80-90% pacjentów z samodzielnie lub lekarsko zdiagnozowanym bólem zatokowym spełniającymi kryteria migreny. Błędne rozpoznania prowadzą do nieadekwatnego leczenia, nadużywania antybiotyków, niepotrzebnych operacji zatok oraz znacznych kosztów ekonomicznych i społecznych, co podkreśla potrzebę poprawy diagnostyki i świadomości klinicznej w tym zakresie.

Epidemiologia bólu zatokowego

Rzeczywista częstotliwość występowania
Błędne diagnozy i ich rozpowszechnienie
Czynniki demograficzne i geograficzne

Nadzór i monitorowanie bólu zatokowego

Badania epidemiologiczne i ich wyzwania
Wyzwania diagnostyczne i konsekwencje błędnych diagnoz
Monitorowanie i strategie poprawy diagnozy
Potrzeby badawcze i edukacyjne

Konsekwencje ekonomiczne i społeczne bólu zatokowego
Wnioski dla praktyki klinicznej

Kolejne rozdziały

Epidemiologia bólu zatokowego

Ból zatokowy jest częstą dolegliwością zgłaszaną przez pacjentów w gabinetach otorynolaryngologów, neurologów i lekarzy podstawowej opieki zdrowotnej. Aktualne dane epidemiologiczne wskazują jednak, że prawdziwy ból zatokowy jest stosunkowo rzadkim schorzeniem, często błędnie diagnozowanym ¹². Według specjalistów z International Headache Society, prawdziwe bóle zatokowe należy uznać za rzadkość, a większość pacjentów z samodzielnie zdiagnozowanym bólem zatokowym w rzeczywistości cierpi na migrenę ³.

Rzeczywista częstotliwość występowania

Badania wskazują, że około 70-80% populacji Ameryki Północnej doświadcza bólów głowy, przy czym 50% odczuwa co najmniej jeden ból głowy miesięcznie, 15% co najmniej jeden tygodniowo, a 5% codziennie ⁴. Istotnym odkryciem jest fakt, że prawdziwy ból zatokowy stanowi zaledwie niewielki odsetek tych przypadków. W przeprowadzonych badaniach klinicznych częstość występowania prawdziwego bólu zatokowego (związanego z zapaleniem zatok) określono na poziomie jedynie 13% wśród pacjentów z przewlekłym zapaleniem zatok ⁵.

W przypadku barosinusitis (urazu ciśnieniowego zatok), częstość występowania wynosi około 3-4 epizody na 100 000 ekspozycji w ogólnie zdrowej populacji, co jest znacznie rzadsze niż urazy ciśnieniowe ucha środkowego, które występują 6-10 razy częściej ⁶. Najczęściej dotknięte są zatoki czołowe, następnie zatoki szczękowe, podczas gdy zatoki sitowe rzadko są izolowanym miejscem schorzenia ⁷.

Błędne diagnozy i ich rozpowszechnienie

Badania konsekwentnie pokazują, że większość pacjentów zgłaszających się z „bólem zatokowym” w rzeczywistości cierpi na inne rodzaje bólów głowy, przede wszystkim migrenę. Według różnych źródeł, od 80% do 90% pacjentów z samodzielnie zdiagnozowanym lub zdiagnozowanym przez lekarza bólem zatokowym w rzeczywistości spełnia kryteria migreny ⁸⁹. Wśród dzieci i młodzieży z przewlekłymi lub nawracającymi bólami głowy, około 40% pacjentów z migreną i 60% pacjentów z bólem typu napięciowego było błędnie zdiagnozowanych jako cierpiący na ból zatokowy ¹⁰.

W badaniu przeprowadzonym w Ameryce Północnej wśród 2991 pacjentów z samodzielnie opisanym lub zdiagnozowanym przez lekarza „bólem zatokowym”, aż 88% spełniało kryteria International Headache Society dla migreny ¹¹. Podobne badanie z Sudanu wykazało, że 34% pacjentów z bólem zatokowym zgłoszonym przez siebie lub zdiagnozowanym przez lekarza spełniało kryteria migreny ¹².

Czynniki demograficzne i geograficzne

Migrena, która jest najczęstszą przyczyną błędnie zdiagnozowanego bólu zatokowego, dotyka około 12% populacji Ameryki Północnej ¹³. Występuje ona częściej u kobiet (20%) niż u mężczyzn (6%), przy czym tylko około 50% przypadków jest właściwie rozpoznanych ¹⁴. Migrena najczęściej dotyka osób w wieku od 20 do 50 lat. U kobiet po 50. roku życia migreny często stają się mniej dotkliwe i mogą ustąpić po menopauzie ¹⁵.

Istotnym czynnikiem ryzyka migreny jest genetyka – około 75% osób cierpiących na migrenę ma rodzinną historię tej choroby ¹⁶. To genetyczne podłoże jest ważne w kontekście błędnych diagnoz, ponieważ nieprawidłowe rozpoznanie bólu zatokowego zamiast migreny może prowadzić do zniekształcenia rodzinnej historii choroby ¹⁷.

Nadzór i monitorowanie bólu zatokowego

Nadzór nad bólem zatokowym stanowi istotne wyzwanie dla systemów opieki zdrowotnej, zwłaszcza w kontekście częstych błędnych diagnoz i nieodpowiedniego leczenia ¹⁸. Badania w tym zakresie koncentrują się zarówno na epidemiologii, jak i na doskonaleniu metod diagnostycznych umożliwiających lepsze różnicowanie prawdziwego bólu zatokowego od pierwotnych bólów głowy.

Badania epidemiologiczne i ich wyzwania

Według Global Burden of Disease (GBD), zaburzenia bólowe głowy należą do najczęstszych i najbardziej upośledzających stanów na całym świecie ¹⁹. Szacowana globalna częstość występowania aktywnych zaburzeń bólowych głowy wynosi 52,0%, migreny 14,0%, bólu głowy typu napięciowego (TTH) 26,0%, a przewlekłych bólów głowy (H15+) 4,6% ²⁰.

Duże różnice w zgłaszanej częstości występowania bólów głowy w różnych krajach, a nawet w obrębie tych samych krajów, są w dużej mierze spowodowane różnicami metodologicznymi między badaniami ²¹. Czynniki metodologiczne przyczyniające się do tych wariancji to m.in.: rok publikacji, wielkość próby, włączenie prawdopodobnych diagnoz, dobór próby z subpopulacji (np. personelu medycznego), metoda pobierania próbek (losowa lub nie), pytanie przesiewowe (neutralne lub kwalifikowane pod względem nasilenia lub przypuszczalnej przyczyny) oraz zakres badania (tylko zaburzenia bólowe głowy lub wiele innych schorzeń) ²².

Wyzwania diagnostyczne i konsekwencje błędnych diagnoz

Jednym z głównych wyzwań w nadzorze nad bólem zatokowym jest tendencja do naddiagnozowania tego schorzenia, zwłaszcza w przypadkach migreny. Badania wskazują, że ból zatokowy jest najczęstszą diagnozą zgłaszaną przez pacjentów z migreną, którzy otrzymali diagnozę inną niż migrena ²³.

Błędne diagnozy lub opóźnione diagnozy prowadzą do szeregu negatywnych konsekwencji, w tym nadużywania antybiotyków, kosztów i ryzyka związanego z operacjami zatok oraz przedłużonego cierpienia ²⁴. Szacuje się, że setki tysięcy osób może być poddawanych nieodpowiednim operacjom zatok i innym terapiom z powodu błędnej diagnozy ²⁵.

W Wielkiej Brytanii 70% bólów głowy nie otrzymuje etykiety diagnostycznej, 24% diagnozuje się jako pierwotne, a 6% jako wtórne bóle głowy. W przypadku tych 6% bólów głowy z dodatkowym opisem, 85% klasyfikuje się jako bóle zatokowe ²⁶. Sugeruje się, że trudności lekarzy POZ w diagnozowaniu prezentacji bólu głowy przyczyniają się do wysokiego poziomu zachorowalności i niezaspokojonych potrzeb w tym obszarze choroby ²⁷.

Monitorowanie i strategie poprawy diagnozy

Aby poprawić dokładność diagnostyczną, zaleca się multidyscyplinarne podejście do oceny pacjentów z bólem zatokowym, które powinno być wprowadzone na wczesnym etapie. Zespół powinien obejmować specjalistę od bólu głowy i rynologa, co pozwoliłoby na prawidłową klasyfikację typu bólu głowy i uniknięcie niepotrzebnych procedur chirurgicznych ²⁸.

Nowe kryteria diagnostyczne dla ostrego zapalenia zatok oparte na charakterystyce bólu mogą również poprawić dokładność diagnoz. Jednostronny, tępy, pulsujący ból głowy i twarzy, o zmiennym nasileniu, trwający cały dzień średnio przez 4-6 godzin, wraz z wcześniejszą krótką historią przeziębienia, jest wysoce czułym kryterium (91%) dla diagnozy ostrego zapalenia zatok ²⁹.

Odpowiedź na leki przeciwmigrenowe może również pomóc w diagnozowaniu migreny i odróżnianiu jej od innych typów bólu głowy ³⁰. Badania wykazały, że leki skuteczne w migrenie i bólu głowy typu napięciowego również zmniejszają objawy bólu zatokowego, co wspiera obserwacje, że ból zatokowy to w większości błędnie zdiagnozowany pierwotny ból głowy ³¹.

Potrzeby badawcze i edukacyjne

Istnieje potrzeba przeprowadzenia większej liczby i lepszych badań w krajach o niskich i średnich dochodach ³². Ponadto, zaleca się, aby pracownicy służby zdrowia postrzegali chorobę migrenową jako formę dezinformacji sensorycznej i jako możliwą etiologię objawów zapalenia zatok ³³.

Potrzebne są również nowe kryteria diagnostyczne dla migreny bez aury i bólu głowy typu napięciowego z towarzyszącymi patologiami zatokowo-nosowymi ³⁴³⁵. Uważa się, że bardziej przydatne badanie powinno określić, jaki odsetek pacjentów z bólem zatokowym faktycznie reaguje na leczenie specyficzne dla migreny ³⁶.

Konsekwencje ekonomiczne i społeczne bólu zatokowego

Błędne diagnozy bólu zatokowego mają znaczące konsekwencje ekonomiczne i społeczne. Ostre zapalenie zatok dotyka 1 na 7 dorosłych w Stanach Zjednoczonych, z ponad 30 milionami osób diagnozowanych każdego roku ³⁷. Zapalenie zatok ma większą częstotliwość występowania od wczesnej jesieni do wczesnej wiosny ³⁸.

Według National Ambulatory Medical Care Survey (NAMCS), około 14% dorosłych zgłasza epizod zapalenia błony śluzowej nosa i zatok każdego roku, a jest to piąta najczęstsza diagnoza, dla której przepisywane są antybiotyki, stanowiąca 0,4% diagnoz ambulatoryjnych ³⁹. W 1996 roku Amerykanie wydali około 3,39 miliarda dolarów na leczenie zapalenia błony śluzowej nosa i zatok ⁴⁰.

Biorąc pod uwagę, że większość tych diagnoz może być błędna, koszty niewłaściwego leczenia, w tym niepotrzebnych antybiotyków i operacji, są znaczące. Badania wykazały, że przeoczenie diagnozy migreny lub opóźnienie w jej rozpoznaniu ma głębokie konsekwencje finansowe i inne ⁴¹.

Z ekonomicznego, społecznego i osobistego punktu widzenia, obciążenie związane z pierwotnymi bólami głowy jest znaczne, a bóle głowy stanowią 4% wszystkich konsultacji u lekarzy ogólnych ⁴². Poprawa dokładności diagnoz i odpowiednie leczenie mogłyby znacząco zmniejszyć to obciążenie.

Typ bólu głowy	Częstość występowania (globalnie)	Procent błędnych diagnoz jako ból zatokowy	Główne objawy podobne do bólu zatokowego
Migrena	14,0%	80-90%	Ucisk zatok, ból zatok, objawy autonomiczne
Ból głowy typu napięciowego	26,0%	Często	Ucisk w okolicy czołowej i skroniowej
Przewlekły ból głowy	4,6%	Zmienny	Długotrwały ból w okolicy zatok
Prawdziwy ból zatokowy	~13% wśród pacjentów z przewlekłym zapaleniem zatok	Nie dotyczy	Ból twarzy, ucisk, objawy nosowe, gęsta wydzielina

¹²³⁴

Wnioski dla praktyki klinicznej

Ból zatokowy (Sinus headache) pozostaje istotnym wyzwaniem diagnostycznym w praktyce klinicznej. Przegląd dostępnych danych epidemiologicznych jednoznacznie wskazuje, że większość przypadków zgłaszanych jako ból zatokowy to w rzeczywistości migrena lub inne pierwotne bóle głowy ⁴³. Konsekwentne błędne diagnozy prowadzą do nieodpowiedniego leczenia, niepotrzebnych kosztów oraz przedłużonego cierpienia pacjentów ⁴⁴.

Dokładna diagnoza wymaga kompleksowej oceny przez specjalistę, często obejmującej szczegółową historię medyczną, badanie fizykalne, a w niektórych przypadkach badania obrazowe ⁴⁵. Multidyscyplinarne podejście, angażujące neurologów i rynologów, jest zalecane na wczesnym etapie diagnostyki ⁴⁶.

Dla efektywnego nadzoru i monitorowania bólu zatokowego niezbędne są lepsze badania epidemiologiczne, zwłaszcza w krajach o niskich i średnich dochodach ⁴⁷. Potrzebne są także nowe kryteria diagnostyczne dla migreny i bólu głowy typu napięciowego z towarzyszącymi patologiami zatokowo-nosowymi ⁴⁸.

Rozpoznanie prawdziwej przyczyny bólu zatokowego jest kluczowe dla właściwego leczenia. W przypadku rzeczywistego zapalenia zatok, leczenie powinno koncentrować się na oczyszczaniu i zmniejszaniu przekrwienia nosa, a w razie potrzeby stosowaniu antybiotyków lub leków przeciwalergicznych ⁴⁹. Natomiast w przypadku migreny, odpowiednie leki przeciwmigrenowe mogą przynieść znaczną ulgę ⁵⁰.

Podsumowując, poprawa świadomości na temat rzeczywistej częstości występowania bólu zatokowego oraz dokładniejsza diagnostyka różnicowa mogą przyczynić się do zmniejszenia obciążenia ekonomicznego i społecznego związanego z tym schorzeniem oraz poprawy jakości życia pacjentów.

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Materiały źródłowe

#1 Headaches Connected to Allergies and Sinus Problems
https://www.aaaai.org/tools-for-the-public/conditions-library/allergies/headaches-connected-to-allergies-and-sinus-problem
Sinus HeadachesAbout 70 to 80% of the North American population has headaches, with 50% experiencing at least one headache per month, 15% experiencing at least one weekly and 5% daily. […] A sinus headache is hard to identify since headache specialists consider true sinus headaches to be fairly rare. […] Headaches attributed to acute bacterial rhinosinusitis are a specific, rare diagnosis. […] Chronic rhinosinusitis is one of the most common problems experienced with allergic rhinitis and can occasionally lead to headaches. […] The majority of people with self-diagnosed sinus headaches are really suffering from migraines, which is why it is important to see a doctor to get a correct diagnosis. […] Research also supports a link between migraine and allergy, so your physician will consider both migraine headache and sinus headache if you are experiencing headaches and allergic rhinitis.
#1 The global prevalence of headache: an update, with analysis of the influences of methodological factors on prevalence estimates | The Journal of Headache and Pain | Full Text
https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-022-01402-2
The estimated global prevalence of active headache disorder was 52.0% (95%CI 48.9-55.4), of migraine 14.0% (12.9-15.2), of TTH 26.0% (22.7-29.5) and of H15+ 4.6% (3.9-5.5). […] These estimates were comparable with those of migraine and TTH in GBD2019, the most recent iteration, but higher for headache overall. […] Methodological factors contributing to variation, were publication year, sample size, inclusion of probable diagnoses, sub-population sampling (e.g., of health-care personnel), sampling method (random or not), screening question (neutral, or qualified in severity or presumed cause) and scope of enquiry (headache disorders only or multiple other conditions). […] More and better studies are needed in low- and middle-income countries.
#2 Sinus headaches – Symptoms & causes – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/sinus-headaches/symptoms-causes/syc-20377580
Sinus headaches are usually associated with migraines or other forms of headaches. […] Sinus headaches are associated with pain and pressure in the face and sinuses and can cause nasal symptoms. Most of these headaches are not caused by sinus infections and generally should not be treated with antibiotics.
#2
https://www.ijorl.com/index.php/ijorl/article/view/1519
We found that only 13% (n=23) cases had chronic rhinosinusitis and hence diagnosed as sinus headache. […] Prevalence of sinus headache in our study was found to be 13%. […] There are high chances of misdiagnosing chronic headache as sinus headache because primary forms of headache can present with nasal symptoms.
#3 Sinus headache: Not what you think – Mayo Clinic Health System
https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/your-sinus-headache-may-not-be-what-you-think
Nearly everyone experiences a headache at some point, and the pain can range from mild to debilitating. […] The term „sinus headache” isn’t an actual medical diagnosis. Studies show that 90% of people with sinus headache symptoms are experiencing migraine headaches. […] Migraine headaches can affect anyone. However, they’re more common in people between age 20 and 50. […] More than twice as many women as men have migraine headaches. Women over 50 often have fewer and less severe migraine headaches than they had earlier in life. Sometimes, migraine headaches stop after menopause. […] Migraine headaches tend to run in families. Seventy-five percent of people with migraine headaches have a family history of migraine headaches. […] The cause of headaches can be challenging to determine. Your healthcare team will ask you questions about your headaches and perform a physical exam. You also may have a CT scan or MRI to help determine the cause of your headache. There are several ways to treat headaches, and your care team will work with you to find the best option for you.
#3 Prevalence of migraine in patients with a history of self-reported or physician-diagnosed „sinus” headache – PubMed
https://pubmed.ncbi.nlm.nih.gov/15364670/
Symptoms referable to the sinus area are frequently reported during migraine attacks, but are not recognized in diagnostic criteria. […] This study was conducted to determine the prevalence of migraine-type headache (International Headache Society [IHS]-defined migraine without aura [IHS 1.1], migraine with aura [IHS 1.2], or migrainous disorder [IHS 1.7]) in patients with a history of self-described or physician-diagnosed „sinus” headache. […] A total of 2991 patients were screened. The majority (88%) of these patients with a history of self-described or physician-diagnosed „sinus” headache were diagnosed at the screening visit as fulfilling IHS migraine criteria (80% of patients) or migrainous criteria (8% of patients). […] In this study, 88% of patients with a history of „sinus” headache were determined to have migraine-type headache. In patients with recurrent headaches without fever or purulent discharge, the presence of sinus-area symptoms may be part of the migraine process. Migraine should be included in the differential diagnosis of these patients.
#4 Headaches Connected to Allergies and Sinus Problems
https://www.aaaai.org/tools-for-the-public/conditions-library/allergies/headaches-connected-to-allergies-and-sinus-problem
Sinus HeadachesAbout 70 to 80% of the North American population has headaches, with 50% experiencing at least one headache per month, 15% experiencing at least one weekly and 5% daily. […] A sinus headache is hard to identify since headache specialists consider true sinus headaches to be fairly rare. […] Headaches attributed to acute bacterial rhinosinusitis are a specific, rare diagnosis. […] Chronic rhinosinusitis is one of the most common problems experienced with allergic rhinitis and can occasionally lead to headaches. […] The majority of people with self-diagnosed sinus headaches are really suffering from migraines, which is why it is important to see a doctor to get a correct diagnosis. […] Research also supports a link between migraine and allergy, so your physician will consider both migraine headache and sinus headache if you are experiencing headaches and allergic rhinitis.
#4 Sinus HeadachesVisit Sinus Service – Southwest Ohio ENT Specialists
https://soents.com/sinus-headaches/
Migraine is commonly misdiagnosed as a sinus headache. Self-diagnosed sinus headache is nearly always migraine (90% of the time). Sinus Headache is a common complaint in the general population. However, sinus headache is not as common as you and others may think. A very large population-based study, entitled American Migraine Study II, showed that many people who were diagnosed with migraine thought they had sinus headache. The most common misdiagnosis was sinus headache. True sinus headache, more properly called rhinosinusitis, is rare and secondary to a viral or bacterial sinus infection characterized by thick, discolored nasal discharge, possibly decreased smell or no smell, facial pain or pressure and commonly fever. In the recent American Migraine Study II, 40% to 70% of respondents with migraine had comorbid allergies. Other studies have reported that people with migraine are 2 to 3.5 times more likely to have comorbid asthma, especially if they have a parent with migraine and asthma. Most sinus headache is misdiagnosed, and these patients may have migraine. Sinus headaches are not normally disabling and migraine headaches are disabling. True sinus headache or sinusitis is associated with a pus-like or purulent nasal discharge that represents a potential infection in the sinuses.
#5
https://www.ijorl.com/index.php/ijorl/article/view/1519
We found that only 13% (n=23) cases had chronic rhinosinusitis and hence diagnosed as sinus headache. […] Prevalence of sinus headache in our study was found to be 13%. […] There are high chances of misdiagnosing chronic headache as sinus headache because primary forms of headache can present with nasal symptoms.
#6 Barosinusitis: Practice Essentials, Pathophysiology, Epidemiology
https://emedicine.medscape.com/article/862964-overview
Prevalence is approximately 3-4 episodes per 100,000 exposures in a generally healthy population. […] In contrast, middle ear barotrauma (aerotitis media) is approximately 6-10 times more prevalent than barosinusitis. […] Frontal sinuses are most often affected, followed by maxillary sinuses. […] Ethmoid sinuses are infrequently affected as isolated events. […] Data are heavily skewed toward people who participate in activities subject to rapid pressure changes. […] A Danish study conducted via questionnaire determined that compared with pilots who had answered the same questionnaire 10 years earlier, the proportion of responding pilots in whom one or more ear-nose-throat (ENT) barotraumas had occurred had increased from 19.5% to 27.9% for barosinusitis and from 37.4% to 55.5% for barotitis media. […] Barosinusitis is not typically reported in children. Frontal sinuses are most frequently affected, and these do not fully develop until late adolescence. In addition, children do not routinely participate in activities that lend themselves to rapid pressure changes.
#7 Barosinusitis: Practice Essentials, Pathophysiology, Epidemiology
https://emedicine.medscape.com/article/862964-overview
Prevalence is approximately 3-4 episodes per 100,000 exposures in a generally healthy population. […] In contrast, middle ear barotrauma (aerotitis media) is approximately 6-10 times more prevalent than barosinusitis. […] Frontal sinuses are most often affected, followed by maxillary sinuses. […] Ethmoid sinuses are infrequently affected as isolated events. […] Data are heavily skewed toward people who participate in activities subject to rapid pressure changes. […] A Danish study conducted via questionnaire determined that compared with pilots who had answered the same questionnaire 10 years earlier, the proportion of responding pilots in whom one or more ear-nose-throat (ENT) barotraumas had occurred had increased from 19.5% to 27.9% for barosinusitis and from 37.4% to 55.5% for barotitis media. […] Barosinusitis is not typically reported in children. Frontal sinuses are most frequently affected, and these do not fully develop until late adolescence. In addition, children do not routinely participate in activities that lend themselves to rapid pressure changes.
#8 Prevalence of migraine in patients with a history of self-reported or physician-diagnosed „sinus” headache – PubMed
https://pubmed.ncbi.nlm.nih.gov/15364670/
Symptoms referable to the sinus area are frequently reported during migraine attacks, but are not recognized in diagnostic criteria. […] This study was conducted to determine the prevalence of migraine-type headache (International Headache Society [IHS]-defined migraine without aura [IHS 1.1], migraine with aura [IHS 1.2], or migrainous disorder [IHS 1.7]) in patients with a history of self-described or physician-diagnosed „sinus” headache. […] A total of 2991 patients were screened. The majority (88%) of these patients with a history of self-described or physician-diagnosed „sinus” headache were diagnosed at the screening visit as fulfilling IHS migraine criteria (80% of patients) or migrainous criteria (8% of patients). […] In this study, 88% of patients with a history of „sinus” headache were determined to have migraine-type headache. In patients with recurrent headaches without fever or purulent discharge, the presence of sinus-area symptoms may be part of the migraine process. Migraine should be included in the differential diagnosis of these patients.
#9
https://abcnews.go.com/Health/PainManagement/story?id=116885&page=1
The vast majority of people who believe they are having sinus headaches are actually having migraines, according to new research presented last week at a meeting of the American Headache Society in Seattle. […] Closer scrutiny of the 2,524 subjects in the study found that their physician-diagnosed or self-described sinus headaches were migraine-type headaches a full 90 percent of the time. […] Involvement of the sinuses is not part of the typical list and may lead many physicians to favor a sinus headache diagnosis. […] „The way that doctors have been trained to diagnose migraine really does not incorporate any of these sinus-like symptoms,” says Schreiber. „We discount those from a diagnostic perspective.”
#10 Sinusitis in children and adolescents with chronic or recurrent headache: a caseâcontrol study | The Journal of Headache and Pain | Full Text
https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1007/s10194-008-0007-0
The aim of this study was to determine the frequency of misdiagnosis of sinus headache in migraine and other primary headache types in the children and adolescents with chronic or recurrent headaches. […] The prevalence of sinus headache concomitant with primary headache, and only sinus headache was detected in 7 and 1%, respectively, in our study. […] Approximately 40% of the patients with migraine and 60% of the patients with tension-type headache had been misdiagnosed as sinus headache. […] Children with chronic or recurrent headaches are frequently misdiagnosed as sinus headache and receive unnecessary sinusitis treatment and sinus graphy. […] Misdiagnosis of migraine is similar in our country to the United States.
#11 Migraine Headache Often Labeled as Sinus Headache | AAFP
https://www.aafp.org/pubs/afp/issues/2005/0115/p354a.html
Patients with frequent sinus headaches may actually have migraine headache. […] This study explored the labeling of patients with frequent headaches. The investigators screened patients at 452 North American primary care sites and identified 2,991 patients with at least six self-described or physician-diagnosed sinus headaches during the six months before screening. […] Eighty-eight percent of these patients met criteria for migraine; yet, 84 percent also reported sinus pressure, and 82 percent reported sinus pain. […] A more useful study would determine what proportion of patients with sinus headaches actually respond to migraine-specific treatment.
#12 Migraine diagnosis in patients with sinus headache symptoms: a cross-sectional study at Khartoum ENT Hospital | The Egyptian Journal of Otolaryngology | Full Text
https://ejo.springeropen.com/articles/10.1186/s43163-025-00758-x
Sinus headache is the most common diagnosis reported by patients with migraine who received a non-migraine diagnosis. […] The prevalence of migraine was 67 (34%); 40 (20%) without aura and 27 (14%) with aura. […] Migraine is not uncommon as 34% of patients with self-reported or physician diagnosed sinus headache meet the International Headache Society (IHS) criteria of Migraine. […] Migraine was associated with autonomic symptoms and a positive family history of migraine. […] The study revealed that migraine was diagnosed in 34% of patients who either self-reported or received a physician’s diagnosis of sinus headaches. […] Migraine was associated with autonomic symptoms and a family history of migraine, distinguishing it from non-migraine headaches. […] Response to antimigraine medications can aid in diagnosing migraine and differentiating it from other headache types.
#13 Sinus Headache, Migraine, and the Otolaryngologist: A Comprehensive Clinical Guide | SpringerLink
https://link.springer.com/book/10.1007/978-3-319-50376-9
This volume will serve as a comprehensive and useful guide for ENT physicians in the recognition, diagnosis, and treatment of patients who suffer from sinus headaches and migraines. […] With 20% of women and 6% of men having migraines (only 50% recognized) this text will serve to expand management options to physicians already operating on sinuses or seeing cosmetic patients with head and neck concerns.
#14 Sinus Headache, Migraine, and the Otolaryngologist: A Comprehensive Clinical Guide | SpringerLink
https://link.springer.com/book/10.1007/978-3-319-50376-9
This volume will serve as a comprehensive and useful guide for ENT physicians in the recognition, diagnosis, and treatment of patients who suffer from sinus headaches and migraines. […] With 20% of women and 6% of men having migraines (only 50% recognized) this text will serve to expand management options to physicians already operating on sinuses or seeing cosmetic patients with head and neck concerns.
#15 Sinus headache: Not what you think – Mayo Clinic Health System
https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/your-sinus-headache-may-not-be-what-you-think
Nearly everyone experiences a headache at some point, and the pain can range from mild to debilitating. […] The term „sinus headache” isn’t an actual medical diagnosis. Studies show that 90% of people with sinus headache symptoms are experiencing migraine headaches. […] Migraine headaches can affect anyone. However, they’re more common in people between age 20 and 50. […] More than twice as many women as men have migraine headaches. Women over 50 often have fewer and less severe migraine headaches than they had earlier in life. Sometimes, migraine headaches stop after menopause. […] Migraine headaches tend to run in families. Seventy-five percent of people with migraine headaches have a family history of migraine headaches. […] The cause of headaches can be challenging to determine. Your healthcare team will ask you questions about your headaches and perform a physical exam. You also may have a CT scan or MRI to help determine the cause of your headache. There are several ways to treat headaches, and your care team will work with you to find the best option for you.
#16 Sinus headache: Not what you think – Mayo Clinic Health System
https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/your-sinus-headache-may-not-be-what-you-think
Nearly everyone experiences a headache at some point, and the pain can range from mild to debilitating. […] The term „sinus headache” isn’t an actual medical diagnosis. Studies show that 90% of people with sinus headache symptoms are experiencing migraine headaches. […] Migraine headaches can affect anyone. However, they’re more common in people between age 20 and 50. […] More than twice as many women as men have migraine headaches. Women over 50 often have fewer and less severe migraine headaches than they had earlier in life. Sometimes, migraine headaches stop after menopause. […] Migraine headaches tend to run in families. Seventy-five percent of people with migraine headaches have a family history of migraine headaches. […] The cause of headaches can be challenging to determine. Your healthcare team will ask you questions about your headaches and perform a physical exam. You also may have a CT scan or MRI to help determine the cause of your headache. There are several ways to treat headaches, and your care team will work with you to find the best option for you.
#17 Sinus headache or sign-us up for a migraine consultation – Harvard Health
https://www.health.harvard.edu/blog/sinus-headache-or-sign-us-up-for-a-migraine-consultation-2016120110758
Many people mistakenly believe their headaches are due to sinus problems when actual reason is migraine. In reality, more than 85% of people who suspect that they have sinus headaches in fact have migraines. […] An incorrect diagnosis of sinus headaches can also serve to skew a patient’s family history. Migraine is a genetic disorder that is passed down through family members. […] In conclusion, if you suffer from frequent sinus headaches, there is a good chance that you are actually experiencing migraines. Making the correct diagnosis and formulating an appropriate treatment plan can reduce the frequency and intensity of headaches, as well as avoid unnecessary testing, visits to specialists, and taking medicines that are not actually treating the problem.
#18 Sinus migraine: A costly blindspot in medical care
https://researchoutreach.org/articles/sinus-migraine-costly-blindspot-medical-care/
Sinus migraine is a frequently overlooked diagnosis and this oversight in clinical care has profound financial and other consequences. […] The review explored the impact of misdiagnosis or delayed diagnosis and found that patients suffer a range of unfortunate consequences including overuse of antibiotics, the cost and risk of sinus surgery and prolonged suffering. […] The authors identified four key factors which support their theory that a sinus migraine mimics sinus infections. […] The authors encourage medical professionals to think of migraine disease as a form of sensory misinformation and as a possible etiology of sinusitis symptoms. […] The team also warn that, under the current guidelines, hundreds of thousands of people may be having inappropriate sinus surgery and other therapies. […] The authors of the review hope that more research into classifying these symptoms will follow.
#19 The global prevalence of headache: an update, with analysis of the influences of methodological factors on prevalence estimates | The Journal of Headache and Pain | Full Text
https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-022-01402-2
According to the Global Burden of Disease (GBD) study, headache disorders are among the most prevalent and disabling conditions worldwide. […] The review confirms GBD in finding that headache disorders remain highly prevalent worldwide, and it identifies methodological factors explaining some of the large variation between study findings. […] Documenting the burden of headache disorders has become an important task, brought to attention by the Global Campaign against Headache. […] GBD estimates are now updated annually to monitor changes in disease burden around the globe, and thereby forecast future needs in health services. […] It is believed that the large variations in reported prevalences from country to country, and sometimes within countries, are to a large extent caused by methodological differences between studies, but this has not been explored empirically.
#20 The global prevalence of headache: an update, with analysis of the influences of methodological factors on prevalence estimates | The Journal of Headache and Pain | Full Text
https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-022-01402-2
The estimated global prevalence of active headache disorder was 52.0% (95%CI 48.9-55.4), of migraine 14.0% (12.9-15.2), of TTH 26.0% (22.7-29.5) and of H15+ 4.6% (3.9-5.5). […] These estimates were comparable with those of migraine and TTH in GBD2019, the most recent iteration, but higher for headache overall. […] Methodological factors contributing to variation, were publication year, sample size, inclusion of probable diagnoses, sub-population sampling (e.g., of health-care personnel), sampling method (random or not), screening question (neutral, or qualified in severity or presumed cause) and scope of enquiry (headache disorders only or multiple other conditions). […] More and better studies are needed in low- and middle-income countries.
#21 The global prevalence of headache: an update, with analysis of the influences of methodological factors on prevalence estimates | The Journal of Headache and Pain | Full Text
https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-022-01402-2
According to the Global Burden of Disease (GBD) study, headache disorders are among the most prevalent and disabling conditions worldwide. […] The review confirms GBD in finding that headache disorders remain highly prevalent worldwide, and it identifies methodological factors explaining some of the large variation between study findings. […] Documenting the burden of headache disorders has become an important task, brought to attention by the Global Campaign against Headache. […] GBD estimates are now updated annually to monitor changes in disease burden around the globe, and thereby forecast future needs in health services. […] It is believed that the large variations in reported prevalences from country to country, and sometimes within countries, are to a large extent caused by methodological differences between studies, but this has not been explored empirically.
#22 The global prevalence of headache: an update, with analysis of the influences of methodological factors on prevalence estimates | The Journal of Headache and Pain | Full Text
https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-022-01402-2
The estimated global prevalence of active headache disorder was 52.0% (95%CI 48.9-55.4), of migraine 14.0% (12.9-15.2), of TTH 26.0% (22.7-29.5) and of H15+ 4.6% (3.9-5.5). […] These estimates were comparable with those of migraine and TTH in GBD2019, the most recent iteration, but higher for headache overall. […] Methodological factors contributing to variation, were publication year, sample size, inclusion of probable diagnoses, sub-population sampling (e.g., of health-care personnel), sampling method (random or not), screening question (neutral, or qualified in severity or presumed cause) and scope of enquiry (headache disorders only or multiple other conditions). […] More and better studies are needed in low- and middle-income countries.
#23 Migraine diagnosis in patients with sinus headache symptoms: a cross-sectional study at Khartoum ENT Hospital | The Egyptian Journal of Otolaryngology | Full Text
https://ejo.springeropen.com/articles/10.1186/s43163-025-00758-x
Sinus headache is the most common diagnosis reported by patients with migraine who received a non-migraine diagnosis. […] The prevalence of migraine was 67 (34%); 40 (20%) without aura and 27 (14%) with aura. […] Migraine is not uncommon as 34% of patients with self-reported or physician diagnosed sinus headache meet the International Headache Society (IHS) criteria of Migraine. […] Migraine was associated with autonomic symptoms and a positive family history of migraine. […] The study revealed that migraine was diagnosed in 34% of patients who either self-reported or received a physician’s diagnosis of sinus headaches. […] Migraine was associated with autonomic symptoms and a family history of migraine, distinguishing it from non-migraine headaches. […] Response to antimigraine medications can aid in diagnosing migraine and differentiating it from other headache types.
#24 Sinus migraine: A costly blindspot in medical care
https://researchoutreach.org/articles/sinus-migraine-costly-blindspot-medical-care/
Sinus migraine is a frequently overlooked diagnosis and this oversight in clinical care has profound financial and other consequences. […] The review explored the impact of misdiagnosis or delayed diagnosis and found that patients suffer a range of unfortunate consequences including overuse of antibiotics, the cost and risk of sinus surgery and prolonged suffering. […] The authors identified four key factors which support their theory that a sinus migraine mimics sinus infections. […] The authors encourage medical professionals to think of migraine disease as a form of sensory misinformation and as a possible etiology of sinusitis symptoms. […] The team also warn that, under the current guidelines, hundreds of thousands of people may be having inappropriate sinus surgery and other therapies. […] The authors of the review hope that more research into classifying these symptoms will follow.
#25 Sinus migraine: A costly blindspot in medical care
https://researchoutreach.org/articles/sinus-migraine-costly-blindspot-medical-care/
Sinus migraine is a frequently overlooked diagnosis and this oversight in clinical care has profound financial and other consequences. […] The review explored the impact of misdiagnosis or delayed diagnosis and found that patients suffer a range of unfortunate consequences including overuse of antibiotics, the cost and risk of sinus surgery and prolonged suffering. […] The authors identified four key factors which support their theory that a sinus migraine mimics sinus infections. […] The authors encourage medical professionals to think of migraine disease as a form of sensory misinformation and as a possible etiology of sinusitis symptoms. […] The team also warn that, under the current guidelines, hundreds of thousands of people may be having inappropriate sinus surgery and other therapies. […] The authors of the review hope that more research into classifying these symptoms will follow.
#26 GPs’ classification of headache: is primary headache underdiagnosed? | British Journal of General Practice
https://bjgp.org/content/58/547/102
In the majority of cases, a primary headache diagnosis is not made at presentation or follow up. […] GPs’ failure to make an accurate diagnosis may contribute to high levels of morbidity and unmet need in this disease area. […] Of the 6% of headache cases that had a further descriptor, 85% were classified as sinus headaches. […] In many cases, GPs may be misdiagnosing sinus pain and missing an underlying presentation of migraine. […] Population studies have reported that migraine is underdiagnosed, and the high level of undiagnosed headaches in this study supports this. […] It may be that GPs require a number of consultations to establish a diagnosis of a primary headache. […] However, only 5.3% of patients with undifferentiated headache received a primary headache diagnosis in the year following presentation. […] Evidence from other studies suggests that it may be partly due to GPs’ failure to make an accurate diagnosis, contributing to the high level of morbidity and unmet need in this disease area.
#27 GPs’ classification of headache: is primary headache underdiagnosed? | British Journal of General Practice
https://bjgp.org/content/58/547/102
With a high economic, social, and personal burden, headache remains an important health problem. […] In this study, a large primary care database was used and diagnostic categories were described for 91 121 adult patients with new-onset headache, that is, patients who had not consulted for headache in the previous year. […] Seventy per cent of headaches were not given a diagnostic label, 24% were diagnosed as primary, and 6% as secondary headaches. […] It is suggested that GPs’ difficulty in diagnosing headache presentations contributes to the high level of morbidity and unmet need in this disease. […] The economic, social, and personal burden of primary headache is substantial, and headache accounts for 4% of all GP consultations. […] This study describes how GPs diagnose new presentations of headache and how this varies with the age of the patient.
#28 Etiology of âSinus HeadacheââMoving the Focus from Rhinology to Neurology. A Systematic Review
https://pmc.ncbi.nlm.nih.gov/articles/PMC7827425/
Medications effective in migraine and tension-type headache also decrease sinus headache symptoms. Although this finding cannot be treated as diagnosis confirmation, it supports observations that sinus headache is mostly misdiagnosed primary headache. […] Multidisciplinary evaluation of patients with sinus headache should be introduced at an early stage. The team should include a headache specialist and rhinologist, as this would allow for the correct classification of headache type and avoidance of unnecessary surgical procedures.
#29 New rapid diagnostic criteria of acute sinusitis based…
https://otorhinolaryngologypl.com/seo/article/01.3001.0011.6821/en
Unilateral, dull aching headache and facial pain, of changing intensity, lasting all day on an average of 4 to 6 hours with a previous short history of common cold in acute sinusitis is the most common pattern observed in this study. […] Unilateral, dull aching headache and facial pain, of variable intensity, lasting all day on an average of 4 to 6 hours along with is highly sensitive criterion (91%) for diagnosis of acute sinusitis. […] The term âSinus headacheâ is a dubious one, as the sinuses themselves are relatively insensitive to pain. […] The most common types of headache and facial pain in clinics present in frontal, ocular, temporal or vertex region are easy to be erroneously concluded as caused by sinus pathology. […] The most common cause of headache in clinical practice is Chronic Tension Type headache and Migraine.
#30 Migraine diagnosis in patients with sinus headache symptoms: a cross-sectional study at Khartoum ENT Hospital | The Egyptian Journal of Otolaryngology | Full Text
https://ejo.springeropen.com/articles/10.1186/s43163-025-00758-x
Sinus headache is the most common diagnosis reported by patients with migraine who received a non-migraine diagnosis. […] The prevalence of migraine was 67 (34%); 40 (20%) without aura and 27 (14%) with aura. […] Migraine is not uncommon as 34% of patients with self-reported or physician diagnosed sinus headache meet the International Headache Society (IHS) criteria of Migraine. […] Migraine was associated with autonomic symptoms and a positive family history of migraine. […] The study revealed that migraine was diagnosed in 34% of patients who either self-reported or received a physician’s diagnosis of sinus headaches. […] Migraine was associated with autonomic symptoms and a family history of migraine, distinguishing it from non-migraine headaches. […] Response to antimigraine medications can aid in diagnosing migraine and differentiating it from other headache types.
#31 Etiology of âSinus HeadacheââMoving the Focus from Rhinology to Neurology. A Systematic Review
https://pmc.ncbi.nlm.nih.gov/articles/PMC7827425/
Medications effective in migraine and tension-type headache also decrease sinus headache symptoms. Although this finding cannot be treated as diagnosis confirmation, it supports observations that sinus headache is mostly misdiagnosed primary headache. […] Multidisciplinary evaluation of patients with sinus headache should be introduced at an early stage. The team should include a headache specialist and rhinologist, as this would allow for the correct classification of headache type and avoidance of unnecessary surgical procedures.
#32 The global prevalence of headache: an update, with analysis of the influences of methodological factors on prevalence estimates | The Journal of Headache and Pain | Full Text
https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-022-01402-2
The estimated global prevalence of active headache disorder was 52.0% (95%CI 48.9-55.4), of migraine 14.0% (12.9-15.2), of TTH 26.0% (22.7-29.5) and of H15+ 4.6% (3.9-5.5). […] These estimates were comparable with those of migraine and TTH in GBD2019, the most recent iteration, but higher for headache overall. […] Methodological factors contributing to variation, were publication year, sample size, inclusion of probable diagnoses, sub-population sampling (e.g., of health-care personnel), sampling method (random or not), screening question (neutral, or qualified in severity or presumed cause) and scope of enquiry (headache disorders only or multiple other conditions). […] More and better studies are needed in low- and middle-income countries.
#33 Sinus migraine: A costly blindspot in medical care
https://researchoutreach.org/articles/sinus-migraine-costly-blindspot-medical-care/
Sinus migraine is a frequently overlooked diagnosis and this oversight in clinical care has profound financial and other consequences. […] The review explored the impact of misdiagnosis or delayed diagnosis and found that patients suffer a range of unfortunate consequences including overuse of antibiotics, the cost and risk of sinus surgery and prolonged suffering. […] The authors identified four key factors which support their theory that a sinus migraine mimics sinus infections. […] The authors encourage medical professionals to think of migraine disease as a form of sensory misinformation and as a possible etiology of sinusitis symptoms. […] The team also warn that, under the current guidelines, hundreds of thousands of people may be having inappropriate sinus surgery and other therapies. […] The authors of the review hope that more research into classifying these symptoms will follow.
#34 Prevalence and etiological causes of sinus headache in 113 consecutive patients with chronic rhinosinusitis [Eastern J Med]
https://eastjmed.org/jvi.aspx?un=EJM-72505&volume=19&issue=2#!
The aim of this article is to examine the prevalence and etiological causes of sinus headache in patients with chronic rhinosinusitis. […] Headache resolved completely in nine (34.6%) out of 26 patients diagnosed with chronic sinusitis and complaining of headache, while partial resolution was seen in five (19.2%) and no change in pain in 12 (46.1%). […] Eleven patients were diagnosed with migraine and five with tension type headache. […] Sinonasal surgery may be beneficial in patients with primary headaches. […] We believe that new diagnostic criteria for migraine without aura and tension type headache accompanied by sinonasal pathologies are now needed.
#35 Prevalence and etiological causes of sinus headache in 113 consecutive patients with chronic rhinosinusitis [Eastern J Med]
https://eastjmed.org/jvi.aspx?pdir=ejm&plng=eng&un=EJM-72505
The aim of this article is to examine the prevalence and etiological causes of sinus headache in patients with chronic rhinosinusitis. […] Headache resolved completely in nine (34.6%) out of 26 patients diagnosed with chronic sinusitis and complaining of headache, while partial resolution was seen in five (19.2%) and no change in pain in 12 (46.1%). […] Sinonasal surgery may be beneficial in patients with primary headaches. […] We believe that new diagnostic criteria for migraine without aura and tension type headache accompanied by sinonasal pathologies are now needed.
#36 Migraine Headache Often Labeled as Sinus Headache | AAFP
https://www.aafp.org/pubs/afp/issues/2005/0115/p354a.html
Patients with frequent sinus headaches may actually have migraine headache. […] This study explored the labeling of patients with frequent headaches. The investigators screened patients at 452 North American primary care sites and identified 2,991 patients with at least six self-described or physician-diagnosed sinus headaches during the six months before screening. […] Eighty-eight percent of these patients met criteria for migraine; yet, 84 percent also reported sinus pressure, and 82 percent reported sinus pain. […] A more useful study would determine what proportion of patients with sinus headaches actually respond to migraine-specific treatment.
#37 Acute Sinusitis: Practice Essentials, Background, Anatomy
https://emedicine.medscape.com/article/232670-overview
Sinusitis affects 1 out of every 7 adults in the United States, with more than 30 million individuals diagnosed each year. Sinusitis is more common from early fall to early spring. Rhinosinusitis affects an estimated 35 million people per year in the United States and accounts for close to 16 million office visits per year. […] According to the National Ambulatory Medical Care Survey (NAMCS), approximately 14% of adults report having an episode of rhinosinusitis each year, and it is the fifth most common diagnosis for which antibiotics are prescribed, accounting for 0.4% of ambulatory diagnoses. […] In 1996, Americans spent approximately $3.39 billion treating rhinosinusitis. […] Acute sinusitis affects 3 in 1000 people in the United Kingdom. Chronic sinusitis affects 1 in 1000 people. Sinusitis is more common in winter than in summer. […] Women have more episodes of infective sinusitis than men because they tend to have more close contact with young children. The rate in women is 20.3%, compared with 11.5% in men.
#38 Acute Sinusitis: Practice Essentials, Background, Anatomy
https://emedicine.medscape.com/article/232670-overview
Sinusitis affects 1 out of every 7 adults in the United States, with more than 30 million individuals diagnosed each year. Sinusitis is more common from early fall to early spring. Rhinosinusitis affects an estimated 35 million people per year in the United States and accounts for close to 16 million office visits per year. […] According to the National Ambulatory Medical Care Survey (NAMCS), approximately 14% of adults report having an episode of rhinosinusitis each year, and it is the fifth most common diagnosis for which antibiotics are prescribed, accounting for 0.4% of ambulatory diagnoses. […] In 1996, Americans spent approximately $3.39 billion treating rhinosinusitis. […] Acute sinusitis affects 3 in 1000 people in the United Kingdom. Chronic sinusitis affects 1 in 1000 people. Sinusitis is more common in winter than in summer. […] Women have more episodes of infective sinusitis than men because they tend to have more close contact with young children. The rate in women is 20.3%, compared with 11.5% in men.
#39 Acute Sinusitis: Practice Essentials, Background, Anatomy
https://emedicine.medscape.com/article/232670-overview
Sinusitis affects 1 out of every 7 adults in the United States, with more than 30 million individuals diagnosed each year. Sinusitis is more common from early fall to early spring. Rhinosinusitis affects an estimated 35 million people per year in the United States and accounts for close to 16 million office visits per year. […] According to the National Ambulatory Medical Care Survey (NAMCS), approximately 14% of adults report having an episode of rhinosinusitis each year, and it is the fifth most common diagnosis for which antibiotics are prescribed, accounting for 0.4% of ambulatory diagnoses. […] In 1996, Americans spent approximately $3.39 billion treating rhinosinusitis. […] Acute sinusitis affects 3 in 1000 people in the United Kingdom. Chronic sinusitis affects 1 in 1000 people. Sinusitis is more common in winter than in summer. […] Women have more episodes of infective sinusitis than men because they tend to have more close contact with young children. The rate in women is 20.3%, compared with 11.5% in men.
#40 Acute Sinusitis: Practice Essentials, Background, Anatomy
https://emedicine.medscape.com/article/232670-overview
Sinusitis affects 1 out of every 7 adults in the United States, with more than 30 million individuals diagnosed each year. Sinusitis is more common from early fall to early spring. Rhinosinusitis affects an estimated 35 million people per year in the United States and accounts for close to 16 million office visits per year. […] According to the National Ambulatory Medical Care Survey (NAMCS), approximately 14% of adults report having an episode of rhinosinusitis each year, and it is the fifth most common diagnosis for which antibiotics are prescribed, accounting for 0.4% of ambulatory diagnoses. […] In 1996, Americans spent approximately $3.39 billion treating rhinosinusitis. […] Acute sinusitis affects 3 in 1000 people in the United Kingdom. Chronic sinusitis affects 1 in 1000 people. Sinusitis is more common in winter than in summer. […] Women have more episodes of infective sinusitis than men because they tend to have more close contact with young children. The rate in women is 20.3%, compared with 11.5% in men.
#41 Sinus migraine: A costly blindspot in medical care
https://researchoutreach.org/articles/sinus-migraine-costly-blindspot-medical-care/
Sinus migraine is a frequently overlooked diagnosis and this oversight in clinical care has profound financial and other consequences. […] The review explored the impact of misdiagnosis or delayed diagnosis and found that patients suffer a range of unfortunate consequences including overuse of antibiotics, the cost and risk of sinus surgery and prolonged suffering. […] The authors identified four key factors which support their theory that a sinus migraine mimics sinus infections. […] The authors encourage medical professionals to think of migraine disease as a form of sensory misinformation and as a possible etiology of sinusitis symptoms. […] The team also warn that, under the current guidelines, hundreds of thousands of people may be having inappropriate sinus surgery and other therapies. […] The authors of the review hope that more research into classifying these symptoms will follow.
#42 GPs’ classification of headache: is primary headache underdiagnosed? | British Journal of General Practice
https://bjgp.org/content/58/547/102
With a high economic, social, and personal burden, headache remains an important health problem. […] In this study, a large primary care database was used and diagnostic categories were described for 91 121 adult patients with new-onset headache, that is, patients who had not consulted for headache in the previous year. […] Seventy per cent of headaches were not given a diagnostic label, 24% were diagnosed as primary, and 6% as secondary headaches. […] It is suggested that GPs’ difficulty in diagnosing headache presentations contributes to the high level of morbidity and unmet need in this disease. […] The economic, social, and personal burden of primary headache is substantial, and headache accounts for 4% of all GP consultations. […] This study describes how GPs diagnose new presentations of headache and how this varies with the age of the patient.
#43 Etiology of âSinus HeadacheââMoving the Focus from Rhinology to Neurology. A Systematic Review
https://pmc.ncbi.nlm.nih.gov/articles/PMC7827425/
Sinus headache and/or facial pain (SH) is a common complaint encountered by otorhinolaryngologists, neurologists and general practitioners. […] The majority of these publications indicate that migraine and TTH are the most prevalent causes of SH, although most of these studies were conducted in a clinical setting. […] This review highlights the fact that the majority of studies recognize migraine as the cause of complaints in patients reporting with sinus headache. […] In conclusion, it seems that lack of a multidisciplinary approach might have resulted in limited diagnostic accuracy in some of studies included in the review. […] Migraine and tension-type headache are the most prevalent causes of complaints in patients reporting to a physician for treatment of sinus headache and facial pain.
#44 Sinus Headaches: Symptoms Causes Treatments Houston The Woodlands TX
https://premiersinus.com/services/sinus-headaches/
Sinus headaches are an uncomfortable symptom of conditions such as sinusitis, rhinosinusitis, or allergic rhinitis that resolve when sinus congestion is effectively treated. […] Research shows that sinus headaches are often inappropriately diagnosed, leading to insufficient or unnecessary treatments that may be harmful, costly, and frustrating for patients. […] In fact, up to 90% of patients who report symptoms of a sinus headache are actually experiencing migraines, tension headaches, or other causes of discomfort unrelated to their sinuses. […] Sinus headaches caused by sinus infections are improved by effectively treating the underlying sinus and nasal problems with proper medications and surgical procedures when necessary. Other causes of headaches such as migraines are more common than sinus problems, and appropriate workup and testing can identify the precise causes and most appropriate treatments without going through unnecessary medications or procedures that are unlikely to provide relief.
#45 Sinus Headaches Unraveled: A Comprehensive Guide to Relief in Cheshire, CT | Naugatuck Valley Ear, Nose, and Throat Associates (NVENTA)
https://naugatuckvalleyent.com/blog/sinus-headaches-understanding-and-addressing-sinus-headaches-in-cheshire-ct/
Sinus headaches are a common ailment that affects millions worldwide, often causing discomfort and disruption to daily life. […] Symptoms of sinus headaches can mimic those of migraines or tension headaches, leading to confusion and misdiagnosis. […] Accurately diagnosing sinus headaches requires a comprehensive evaluation by a healthcare professional, often involving a thorough medical history, physical examination, and, in some cases, imaging studies. […] Once diagnosed, treatment options for sinus headaches vary depending on the severity and frequency of symptoms. […] Preventing sinus headaches often involves a multifaceted approach that addresses both symptomatic relief and underlying triggers. […] Furthermore, ongoing communication with healthcare providers is crucial for long-term management of sinus headaches. […] Sinus headaches can be a source of considerable discomfort and frustration, but they are not insurmountable.
#46 Etiology of âSinus HeadacheââMoving the Focus from Rhinology to Neurology. A Systematic Review
https://pmc.ncbi.nlm.nih.gov/articles/PMC7827425/
Medications effective in migraine and tension-type headache also decrease sinus headache symptoms. Although this finding cannot be treated as diagnosis confirmation, it supports observations that sinus headache is mostly misdiagnosed primary headache. […] Multidisciplinary evaluation of patients with sinus headache should be introduced at an early stage. The team should include a headache specialist and rhinologist, as this would allow for the correct classification of headache type and avoidance of unnecessary surgical procedures.
#47 The global prevalence of headache: an update, with analysis of the influences of methodological factors on prevalence estimates | The Journal of Headache and Pain | Full Text
https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-022-01402-2
The estimated global prevalence of active headache disorder was 52.0% (95%CI 48.9-55.4), of migraine 14.0% (12.9-15.2), of TTH 26.0% (22.7-29.5) and of H15+ 4.6% (3.9-5.5). […] These estimates were comparable with those of migraine and TTH in GBD2019, the most recent iteration, but higher for headache overall. […] Methodological factors contributing to variation, were publication year, sample size, inclusion of probable diagnoses, sub-population sampling (e.g., of health-care personnel), sampling method (random or not), screening question (neutral, or qualified in severity or presumed cause) and scope of enquiry (headache disorders only or multiple other conditions). […] More and better studies are needed in low- and middle-income countries.
#48 Prevalence and etiological causes of sinus headache in 113 consecutive patients with chronic rhinosinusitis [Eastern J Med]
https://eastjmed.org/jvi.aspx?un=EJM-72505&volume=19&issue=2#!
The aim of this article is to examine the prevalence and etiological causes of sinus headache in patients with chronic rhinosinusitis. […] Headache resolved completely in nine (34.6%) out of 26 patients diagnosed with chronic sinusitis and complaining of headache, while partial resolution was seen in five (19.2%) and no change in pain in 12 (46.1%). […] Eleven patients were diagnosed with migraine and five with tension type headache. […] Sinonasal surgery may be beneficial in patients with primary headaches. […] We believe that new diagnostic criteria for migraine without aura and tension type headache accompanied by sinonasal pathologies are now needed.
#49 Sinuses can be a pain in the head, not neck
https://www.bcm.edu/news/sinuses-can-be-a-pain-in-the-head-not-neck
That troublesome headache might not be a migraine or brought on by tension. It could be caused by sinus trouble, said doctors at Baylor College of Medicine. […] Sinus headaches usually occur along with congestion. The drainage passageways of the sinuses into the nose can get blocked and fluid can accumulate in the sinuses, causing pressure. Many things can cause sinus pressure and pain, such as sinus infections, nasal allergies, nasal polyps, septal deviations as well as enlarged vascular structures in the nose called turbinates. […] Therapy is based on cleansing and decongesting the nose. This can be accomplished with something as simple as nasal irrigation using salt water. Steam, as found in a hot shower, may also provide decongestion and relief. If the problem is caused by infection then antibiotics are used. If it is allergy related, allergy medications may be prescribed. Occasionally surgery is required to keep the passages open.
#50 Migraine diagnosis in patients with sinus headache symptoms: a cross-sectional study at Khartoum ENT Hospital | The Egyptian Journal of Otolaryngology | Full Text
https://ejo.springeropen.com/articles/10.1186/s43163-025-00758-x
Sinus headache is the most common diagnosis reported by patients with migraine who received a non-migraine diagnosis. […] The prevalence of migraine was 67 (34%); 40 (20%) without aura and 27 (14%) with aura. […] Migraine is not uncommon as 34% of patients with self-reported or physician diagnosed sinus headache meet the International Headache Society (IHS) criteria of Migraine. […] Migraine was associated with autonomic symptoms and a positive family history of migraine. […] The study revealed that migraine was diagnosed in 34% of patients who either self-reported or received a physician’s diagnosis of sinus headaches. […] Migraine was associated with autonomic symptoms and a family history of migraine, distinguishing it from non-migraine headaches. […] Response to antimigraine medications can aid in diagnosing migraine and differentiating it from other headache types.