Sinus Congestion or Headache vs Head Congestion (Migraine)
Headaches are a common symptom and initial symptoms of Facial pain, headache and congestion can be confusing to make a diagnosis of Sinusitis or Migraine. Sinus headaches occur in the area of cheeks, between the eyes, or deep seated pain. Patients usually complain of Facial heaviness, feeling of fullness in the head. It is usually associated with nasal discharge trickling down the throat, and nose block.
Initial episodes of cold may resolve in a week, but there can be persistent headaches and facial congestion. This is termed as Chronic Rhinosinusitis and patients may also have facial swelling, swelling below the eyes and skin discoloration.
What is Sinus?
Sinuses are air filled cavities in the facial skeleton. These are present to make the skull light. These cavities are connected with the nasal cavities through narrow openings. These spaces are lined with nasal mucosa which produces mucus round the clock. This mucus humidifies the air we breathe. Repeated colds cause swelling of the sinus mucosa leading to blockage of the narrow sinus opening and drainage pathways. Sinus headaches are caused by accumulation of mucus in facial sinuses.
Symptoms of Sinus?
Chronic sinus symptoms can be mistakenly diagnosed as Migraine. Patients with Migraine present with abrupt onset of headaches which are usually one sided and persist for long, until the patient takes a pain killer or takes rest. The pain can also be in front of the head, facial area and may radiate to behind the head and neck. These patients are irritable during the episode, avoiding light and sound. Nausea is a common associated symptom. The headaches have a preceding stimulating factor like stress, fasting, exposure to sunlight etc. Sometimes a sinus headache can also trigger a Migraine.
Treatment for Sinus
These patients need a thorough evaluation by an ENT. Patients may also undergo a nasal endoscopy and a CT scan for diagnosis. These patients are initially treated with decongestant medications, nasal sprays, saline nasal washes. Some patients with persistent symptoms need sinus surgery for relief. Sinus surgery also known as FESS (functional endoscopic sinus surgery) is a day care endoscopic procedure. The aim of the surgery is to widen the sinus openings preventing repeated infections and headaches. It improves the functioning of the sinuses.
Migraine headaches are caused by impromptu firing of neural networks in the brain. Migraine patients are treated with painkillers to decrease the headache inane anxiety episode. They also are given prophylactic medication to decrease the acute episodes.
It is important to differentiate Sinus headaches from migraines as the treatment protocols are completely contrasting.
References:
- Nasal congestion, Mayo Clinic: https://www.mayoclinic.org/symptoms/nasal-congestion/basics/definition/sym-20050644
- What You Need to Know About Sinusitis, Healthline: https://www.healthline.com/health/sinusitis
- What Is Sinusitis? WebMD: https://www.webmd.com/allergies/sinusitis-and-sinus-infection
About Author –
Dr. Manusrut, Consultant ENT, Head & Neck Surgeon, Yashoda Hospital, Hyderabad
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