Headache and rhinosinusitis: A review

Cephalalgia. 2021 Apr;41(4):453-463. doi: 10.1177/0333102420959790. Epub 2020 Sep 20.


Purpose of review: To explain our current understanding of headache attributed to rhinosinusitis, an often inappropriately diagnosed secondary headache.

Recent findings: Recent studies have shown that headache attributed to rhinosinusitis is often over-diagnosed in patients who actually have primary headache disorders, most commonly migraine. Failure to recognize and treat rhinosinusitis, however, can have devastating consequences. Abnormalities of the sinuses may also be treatable by surgical means, which may provide headache relief in appropriately selected patients.

Summary: It is important for the practicing physician to understand how rhinosinusitis fits into the differential diagnosis of headache, both to avoid overdiagnosis in patients with primary headache, and to avoid underdiagnosis in patients with serious sinus disease.

Keywords: Headache; contact point headache; migraine; rhinosinusitis; sinusitis; sphenoid sinusitis.

Publication types

  • Review

MeSH terms

  • Diagnosis, Differential
  • Headache / diagnosis
  • Headache / etiology*
  • Humans
  • Migraine Disorders / diagnosis*
  • Rhinitis / complications*
  • Rhinitis / diagnosis
  • Sinusitis / complications*
  • Sinusitis / diagnosis