Sinus Headaches

Sinus headaches are a common complaint and can be a source of considerable pain and discomfort. They have a number of causes and a careful assessment is needed to make the correct diagnosis and plan the appropriate treatment.

What is a “sinus headache”?

A sinus headache is a term used to describe facial pain or headaches that are due to either a blockage of air entering and leaving a sinus or due to fluid or infection build-up within the sinus. Sinus headaches can occur due to blockage of any of the sinuses – maxillary, ethmoid, sphenoid or frontal. Each sinus has distinctive patterns of sinus headache. For example, blockage of the maxillary sinuses tends to be felt over the cheeks, ethmoid sinuses over the bridge of the nose and around the eyes, frontal sinuses up in the forehead. Isolated sphenoid sinus problems often cause a vague dull headache which is not easily localised.

Can my “sinus headache” be serious?

Sinus headaches can be a sign of a serious infection or of a problem that has nothing to do with the sinuses. There are many causes of headaches but some can be serious. If the headache is new, prolonged or recurrent it warrants a review by your GP and a referral to either an Ear, Nose and Throat specialist or a neurologist. If you are worried at all, you should see your GP.

How do I know if a headache is definitely a “sinus headache”?

Your sinuses can become blocked by many causes of swelling in the nose. These include allergies, acute or chronic infections, sudden changes in altitude (eg flying) or trauma. An infection can also cause a collection of pus or fungus to collect in a sinus putting pressure on the walls and causing pain. Infections in the sinus can come from the nasal cavity but also from an infected tooth or from the bloodstream.

Typically a sinus headache is associated with other nasal symptoms such as nasal congestion or blockage, a runny nose or post-nasal drip. However these are sometimes absent. During a consultation an Ear, Nose and Throat specialist can assess the drainage pathways of some sinuses directly via a procedure called Nasendoscopy. A CT scan of the sinuses is often helpful to assess the size of the openings into sinuses and look for any blockages that may cause a sinus headache.

What are the treatment options?

Sinus headaches have a number of causes and treatment will focus on treating the specific cause. This may involve allergy treatment, sprays in the nose to help improve airflow or possibly even surgery (endoscopic “keyhold” sinus surgery) to widen the openings of the sinuses. An ear, nose and throat specialist will be able to assess you and arrange the appropriate investigations and treatment.

Dr Roth is an Ear, Nose and Throat surgeon with subspeciality training and interest in disorders of the nose and sinuses including sinus headaches.