Headache of Nasal Origin

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The majority of patients in their quest for relief from headache consult a rhinologist at some stage of their illness. It has been found that a large proportion of these patients believe they have sinus trouble, and in many instances, they have been advised by even their own doctor that their headache is due to a sinus infection.

Two very definite statements may be made in regard to headache of nasal origin—first, the sinuses and upper respiratory tract are not a frequent cause, and second, headache is not one of the outstanding symptoms of sinus disease. Years ago, Gruenwald of Vienna taught that headache was present in one hundred per cent of the cases of acute sinus disease and in fifty per cent of the chronic cases. A recent analysis of a series of new cases seen in the nose and throat department of the Cleveland Clinic revealed that headache was a symptom in only twenty-seven of two hundred ninety-five consecutive cases of sinus infection, and of these, twenty-five were acute cases. Therefore, of two hundred and seventy cases of chronic sinusitis, pain, or headache was the chief complaint in only two cases—less than one per cent. This great change in statistics is due to a more thorough search for the cause of the headache and to better diagnoses.

By far the most common symptom of sinus disease is a post-nasal discharge. This was the chief symptom in eighty cases. Other symptoms in order of their frequency were nasal discharge, recurring. . .



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