Otolaryngologic evaluation and management of headache

Headache is a very common complaint that tends to be nonspecific and is generally associated with few physical findings. These patients frequently present to an otolaryngologist to determine whether the pain is sinus related. Although one of the primary headache syndromes remains the most common cause of head pain, very often a rhinogenic etiology may be overlooked. Rhinogenic headache may occur without other nasal and sinus symptoms, and therefore the otolaryngologist must rely on a thorough examination that should include nasal endoscopy. This paper reviews the primary headache syndromes, as well as the characteristics and appropriate techniques for diagnosing rhinogenic headache.