Objective:

To describe the clinical features and final headache diagnoses of patients with prominent craniofacial pain who were referred by a rhinologist to a headache specialist.

Background:

Many patients with craniofacial pain are misdiagnosed with “sinus headache” and are often referred to otolaryngologists for evaluation of sinus disease. However, the benefit of collaboration between rhinologists and headache specialists for evaluation of patients with putative sinus headache has not been studied.

Design/Methods:

We conducted a single-center retrospective case series of patients who saw a rhinologist for craniofacial pain and were subsequently referred to a headache specialist for presumed non-sinogenic craniofacial pain between January 2016 and March 2019. SNOT-22 (Sino-Nasal Outcome Test-22 questionnaire) score, ICHD (International Classification of Headache Disorders) diagnosis, patient characteristics, endoscopy results, and headache characteristics were assessed.

Results:

Of 98 patients, 73 (74.5%) were female, the mean age was 50.9 years, and the mean SNOT-22 score was 48.6. Nasal endoscopy performed in the rhinology clinic revealed normal results in 90 (92.7 %) patients, edema was noted in 4 (5.2%) patients, and mucopurulence in 2 (2%) patients. Most patients described their pain as frontal or frontal-maxillary, dull or throbbing, and moderate to severe. Migraine (episodic and chronic) was the most common final diagnosis in 48 (49.0 %) patients, and the second most common diagnosis was tension-type headache in 17 (17.3%) patients.

Conclusions:

Patients referred from a rhinologist to a headache specialist for non-sinogenic craniofacial pain are likely to have a final diagnosis of a primary headache disorder, specifically migraine or tension-type headache, rather than a true sinus-related disorder. Collaboration between specialists may improve diagnostic accuracy and outcomes for patients with craniofacial pain that may be confused for sinus headache.