Abstract

Sinonasal disease has well been regarded as a common cause for headache particularly in general public. Headache associated with acute or chronic sinusitis is well recognized entity, the diagnosis is easily made due to association of nasal and sinus symptoms. However, in real medical practice, the exact diagnosis of headache of sinonasal origin has been a challenging subject. In otolaryngologic perspectives, headaches can be classified as; Headache specifically linked to sinonasal abnormalities, headache unrela- ted to sinonasal cause, an entity with no clear cause for headache in which sinus origin cannot be clearly identified. The commonly encountered diagnostic entities presenting with headaches from sinonasal origin are acute rhinosinusitis, chronic rhinosinusitis, fungal sinusitis, sinus mucocele, sinonasal tumor, and con- tact point headache. Among these, the significance of contact point headache has been a debate. Cer- tainly, it is a diagnostic challenge for the physician to diagnose headache of sinonasal origin when the radiography and endoscopy are negative, and there is no clear history of sinonasal symptoms. To better diagnose the headache of sinonasal origin, the nose and paranasal sinuses should be included when imaging study for brain is requested. Furthermore, based on strong interaction between neurologist and otolaryngologist, an active consultation and thoughtful examination of nose and paranasal sinuses by the otolaryngologist is strongly mandated. Korean Journal of Headache 4(2):89-93, 2003