Headaches, sinus - Sinusitis What are sinus headaches?

The sinuses are open cavities in facial and head bones. It is believed that these air spaces enable humans to hold up their heads. If the areas occupied by sinuses were filled with bone or tissue, the head would be extremely heavy. There are four groups of sinuses: the frontal sinuses, which are located just above the eyes; the ethmoid sinuses, which are in the cheek area; the maxillary sinuses, which are located on both sides of the nose and spread out under the cheeks; and the sphenoid sinuses, which are in front of the ears. The sinuses are lined with mucous membranes, similar to those that line the nose, and are connected to the nasal passages by ducts. Sinus headaches occur when the mucous membranes are clogged or inflamed, a process known as sinusitis, which may accompany a severe cold. SYMPTOMS

Headache pain just above the eyes and/or on either side of the nose. Morning headache that can be exacerbated or relieved by moving your head in certain ways. Nasal congestion. What causes sinus headaches?

The inflammation that causes a sinus headache is usually triggered by a bacterial or a viral infection that starts in the nose and spreads to the sinuses. The most likely cause is a common cold, which is caused by a virus. In some cases, the inflammation can be caused by persistent allergies affecting the upper respiratory system. Alternatively, the inflammation may be triggered by irritation due to heavy smoking. Less commonly, the infection may originate in a nearby tooth abscess. In some instances, a secondary bacterial infection

Sinus headaches are caused by inflammation of the mucous membranes that line the sinuses. occurs in the presence of a cold or allergy. As mucus builds in the area and membranes swell, the passages from the nose to the sinuses become closed. Infected material cannot drain through the nose, and painful pressure builds up, resulting in a headache. How are sinus headaches diagnosed and treated? A diagnosis of sinusitis is usually based on a medical history, the presence of characteristic symptoms, and a physical examination of the nose and mouth area. In addition, an x-ray of the sinuses can confirm a questionable diagnosis. Treatment depends on the underlying cause. What can I do myself? Use a humidifier or vaporizer to add moisture to the air, or take frequent hot showers in order to inhale moist steam. Avoid going out in cold weather. If you smoke, stop, and avoid smoke-filled environments as much as possible. Use over-the-counter decongestants cautiously and never for more than two days. They can cause rebound problems that worsen symptoms. When should I see my doctor? If self-help does not bring improvement within a few days, consult a physician. What will the doctor do? The first step is getting symptomatic relief. The physician may prescribe medication to re-establish drainage. If the likely cause is viral, further treatment is probably unnecessary. If an allergy underlies the problem, an antihistamine or allergy shots may be used. A bacterial infection can be treated with antibiotics. In persistent, chronic cases, the doctor may recommend sinus drainage. This is a surgical procedure that involves washing out the sinuses with sterile water. The course of sinus headaches

Sinus headaches occur in the presence of nasal congestion. Discomfort tends to be worse when arising in the morning or when leaning over. The base of the forehead may be tender. Sometimes a low-grade fever occurs. Are sinus headaches dangerous? Usually not, but they can be uncomfortable. In rare cases, an untreated bacterial sinus infection can be transmitted to the brain, becoming life threatening.

IRRITATION OF THIS NERVES MAY CAUSE HEADCHE FOR MANY PATIENTS The trigeminal nerve (cranial nerve V) and its constituent 3 major branches provide most somatosensory innervation to the head and face region. The trigeminal nerve originates in the lateral pons then divides into the following 3 divisions from the gasserian ganglion: the ophthalmic (V-1), the maxillary (V-2), and the mandibular (V-3) divisions. The ophthalmic division (V-1) provides sensory innervation to most of the upper third of the head and face, including (but not limited to) the skin of the eyelids, eyebrow, forehead, and nose and part of the mucous membranes of the nasal cavity.3 Ethmoidal branches supply the mucous membranes of the ethmoid sinuses. An intracranial branch called the tentorial nerve of Arnold supplies the tentorium, superior surface of the transverse and straight dural sinuses, and the inferior two thirds of the falx cerebri.4 The maxillary division (V-2) innervates several key areas in the midface region including the upper teeth, the floor and anterior region of the nasal cavity, and the skin of the lateral nose and malar region. The sphenopalatine branches innervate the lining of the maxillary sinuses, and the middle meningeal branch supplies portions of the floor of the middle fossa dura.5 The mandibular branch (V-3) supplies the teeth and gums of the mandible, the skin of the lower face, the temporomandibular joint (TMJ) and also the dura of the lateral portion of the middle fossa and most of the cranium.5 The trigeminal system is the main source for sensory innervation to the supratentorial dura, venous sinuses, and meningeal arteries. The 7th, 9th, and 10th cranial nerves also contain somatosensory pain fibers that synapse with trigeminal pain axons.5

Sinogenic Facial Pain and Headache Sinusitis The International Headache Society (IHS) classification system lists the following criteria for a diagnosis for sinus headache:6 1. Frontal headache that is accompanied by pain in one or more regions of the face, ears, or teeth and that fulfills criteria C and D 2. Clinical, nasal endoscopic, or CT and/or MRI and/or laboratory evidence of acute or acute-on-chronic rhinosinusitis 3. Headache and facial pain that develop simultaneously with the onset or acute exacerbation of rhinosinusitis 4. Headache, facial pain, or both that resolve within 7 days of remission or successful treatment of acute or acute-on-chronic rhinosinusitis Most sinonasal pain is referred and is deep, aching, and usually nonpulsatile. The location of pain can help localize which sinus may be particularly involved, as follows:7

Frontal sinus - Frontal, vertex, and retro-orbital pain Maxillary sinus - Malar region and upper teeth pain Ethmoid sinus - Nasion and retro-orbital pain and pain that radiates to the temporal area Sphenoid sinus - Vertex, occipital, frontal, and retro-orbital pain