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An in-depth comparison between sinus headaches and migraines, written by Dr. John M. DelGaudio, a Professor and Vice Chair at Emory University School of Medicine. the differences and similarities between the two conditions, including symptoms, diagnosis, and treatment. It also discusses the Rhinosinusitis Task Force's definition of sinusitis and the classification of facial pain of rhinogenic origin.
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John M. DelGaudio, MD, FACS Professor and Vice Chair Chief of Rhinology and Sinus Surgery Department of Otolaryngology Emory University School of Medicine
EMORY HEALTHCAREEMORY HEALTHCARE
Rhinosinusitis Task Force: Sinusitis Defined
Rhinosinusitis Task Force: Sinusitis Defined MajorFactors Facial Pain/Pressure- MUST beassociated with ANOTHER major factor Facial Congestion/fullness Nasal Obstruction/blockage Nasal Discharge/drainage Hyposmia/anosmia Fever (in acute) MinorFactors Headache Fever Halitosis Fatigue Dental pain Cough Ear pain/fullness/pressure
http://www.powerpak.com/courses/10132/Figure3.jpg
EMORY HEALTHCAREEMORY HEALTHCARE Benninger^ et^ al (2003); Lanza and Kennedy (1997)
Facial Pain of Rhinogenic Origin Classification
Facial Pain of Rhinogenic Origin Classification
Rhinogenic Pain My Rules of Thumb
Rhinogenic Pain My Rules of Thumb
DelGaudioDelGaudio JM, Wise SK, Wise JC. Association of Radiologic Evidenceof Frontal Sinus Disease with the Presence of Frontal Pain.of Frontal Sinus Disease with the Presence of Frontal Pain.JM, Wise SK, Wise JC. Association of Radiologic Evidence AmerAmer J Rhinology 2005;167J Rhinology 2005;167--73 73
DelGaudioDelGaudio JM, Wise SK, Wise JC. Association of Radiologic Evidenceof Frontal Sinus Disease with the Presence of Frontal Pain.of Frontal Sinus Disease with the Presence of Frontal Pain.JM, Wise SK, Wise JC. Association of Radiologic Evidence AmerAmer J Rhinology 2005;167J Rhinology 2005;167--73 73
OpacificationOpacification MildMild-mucosal thickeningmucosal thickening-toto--moderatemoderate (>3 mm diffuse/circumferential(>3 mm diffuse/circumferentialmucosal thickening)mucosal thickening)
Minimal mucosalMinimal mucosal thickeningthickening (<3 mm mucosal(<3 mm mucosal thickening in a dependentthickening in a dependentposition)position) IntermediateIntermediate Most painMost pain Least painLeast pain Non-polyp patients had more pain than polyp patients
What about the patient with “SINUS HEADACHE” and a normal CT scan? i.e. no inflammatory sinusitis
Does this represent a rhinogenic source or migraine headache?
What about the patient with “SINUS HEADACHE” and a normal CT scan? i.e. no inflammatory sinusitis
Does this represent a rhinogenic source or migraine headache?
International Headache Society: Classic Migraine Defined
International Headache Society: Classic Migraine Defined Migraine with Aura
Headache Classification Subcommittee of the International Headache Society (2004)
EMORY HEALTHCAREEMORY HEALTHCARE
“Sinus Headache” is Usually Migraine
“Sinus Headache” is Usually Migraine
Diagnostic and Therapeutic Dilemma of “Sinus Headache”
Diagnostic and Therapeutic Dilemma of “Sinus Headache”
EMORY HEALTHCAREEMORY HEALTHCARE
Causes of Headache in Patients with Primary Diagnosis of Sinus Headache
Causes of Headache in Patients with Primary Diagnosis of Sinus Headache
Foroughipour M, et al. Eur Arch Otorhinolaryngol 2011;268:1593-