Headache and Facial Pain—The Role of the Paranasal Sinuses: a Literature Review

ABSTRACT

Long neglected as a clinical entity, sinus headache has become a common complaint of patients with facial pain. Although pain is associated with some sinus disease, many experts feel the magnitude and instances of sinus headache have been exaggerated to the public. Birt¹ stated that “otolaryngologists see scores of patients with vague discomfort in the forehead, between the eyes, and across the nose and cheeks.” Patients invariably ascribe their symptoms to sinus disease, and are later surprised to discover that they are not infected. In fact, chronic sinusitis is not particularly common, and many headache patients with autonomic features will probably have muscle tension headaches or migraines. Most authors feel that acute or chronic headache processes are not a result of overt paranasal sinus disease. However, the clinician is obliged to consider the possibility in differential diagnosis.² This paper will present the anatomic, neurologic, physiologic, and pathologic aspects of paranasal sinus disease and its conceivable relationship to headache and facial pain.

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David I. Schor

Dr. David I. Schor received his D.D.S. degree from Georgetown University, School of Dentistry in 1976. He completed the two year continuing education program in the diagnosis and management of orofacial pain and temporomandibular joint disorders at the University of Medicine and Dentistry of New Jersey-New Jersey Dental School. He is currently in private practice in Lawrenceville, New Jersey, is Director of Dental Services at St. Lawrence Rehabilitation Hospital, and is an instructor in TMJ disorders at Mercer County College. Dr. Schor is a member of the American Association of the Study of Headache, Fellow of the Academy of General Dentistry and a Diplomate of the American Academy of Pain Management.