HEADACHE AND FACIAL PAIN

We as doctors come across, complaints of headache, very often especially in ENT speciality in the form of facial pain due to sinusitis and  headache due to septal deviation of the nose and jaw joint problems to name a few. 

Sometimes facial pain can be due to fifth cranial nerve  nucleus sensitization. So by proper history and examination, doctors have to differentiate ,aches due to sinus pathology from nonsinus pathology, which warrants lot of patience and experience. 

Sinus facial pain is best expressed as pressure, fullness, throbbing in the sinus area (four  types of sinuses) or at the vertex. Facial pain can be on one side or both sides. There will be diurnal variations and associated symptoms like, nasal congestion, smell disturbances. Doctors have to ask leading questions in order to make a correct diagnosis. 

One has to keep in mind that sometimes, very severe case of sinusitis with pus inside, may NOT be presenting with any pain or head ache also. 

TREATMENT depends on various factors, associated comorbidites like diabetes. 

Medical management  is  opted  first in the definitive and symptomatic treatment and only for resistant cases or chronic cases ,sinus surgery  is opted. 

Details of Sinusitis will be discussed later. Non sinus causes of headache will be explained one by one.