Skip to main content

Rhinogenic Headache in Children and Adolescents

Current Pain and Headache Reports volume 24, Article number: 7 (2020) Cite this article

Abstract

Purpose of Review

The purpose of this review is to evaluate and explain our current understanding of rhinogenic headache in the pediatric population.

Recent Findings

One study showed that 40 % of pediatric patients with migraine had previously received an incorrect diagnosis of sinus headache. Two studies found that over 50% of pediatric patients with migraines have associated cranial autonomic symptoms, possibly elucidating the reasons for misdiagnosis. Some case reports demonstrate successful treatment of rhinogenic contact point headache with the surgical resection of mucosal contact points, although this diagnosis continues to be debated.

Summary

Many pediatric patients diagnosed with a sinus-related headache actually meet criteria for primary headache disorders. Primary headache disorders should be considered in pediatric patients with headache and associated rhinologic symptoms. Some literature suggests that mucosal contact point headaches can be surgically treated in children, but the level of evidence is inadequate, and additional robust trials are needed.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

USD 39.95

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2018;38(1):1–211. https://doi.org/10.1177/0333102417738202.

  2. Levine HL, Setzen M, Cady RK, Dodick DW, Schreiber CP, Eross EJ, et al. An otolaryngology, neurology, allergy, and primary care consensus on diagnosis and treatment of sinus headache. Otolaryngol Head Neck Surg. 2006;134(3):516–23. https://doi.org/10.1016/j.otohns.2005.11.024.

    Article  PubMed  Google Scholar 

  3. Schreiber CP, Hutchinson S, Webster CJ, Ames M, Richardson MS, Powers C. Prevalence of migraine in patients with a history of self-reported or physician-diagnosed "sinus" headache. Arch Intern Med. 2004;164(16):1769–72. https://doi.org/10.1001/archinte.164.16.1769.

    Article  PubMed  Google Scholar 

  4. Patel ZM, Kennedy DW, Setzen M, Poetker DM, DelGaudio JM. "sinus headache": rhinogenic headache or migraine? An evidence-based guide to diagnosis and treatment. Int Forum Allergy Rhinol. 2013;3(3):221–30. https://doi.org/10.1002/alr.21095.

    Article  PubMed  Google Scholar 

  5. Patel ZM, Setzen M, Poetker DM, DelGaudio JM. Evaluation and management of "sinus headache" in the otolaryngology practice. Otolaryngol Clin N Am. 2014;47(2):269–87. https://doi.org/10.1016/j.otc.2013.10.008.

    Article  Google Scholar 

  6. Eross E, Dodick D, Eross M. The sinus, allergy and migraine study (SAMS). Headache. 2007;47(2):213–24. https://doi.org/10.1111/j.1526-4610.2006.00688.x.

    Article  PubMed  Google Scholar 

  7. •• Senbil N, Gurer YK, Uner C, Barut Y. Sinusitis in children and adolescents with chronic or recurrent headache: a case-control study. J Headache Pain. 2008;9(1):33–6. https://doi.org/10.1007/s10194-008-0007-0Misdiagnosis of primary headache disorders as sinus headache.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Cady RK, Dodick DW, Levine HL, Schreiber CP, Eross EJ, Setzen M, et al. Sinus headache: a neurology, otolaryngology, allergy, and primary care consensus on diagnosis and treatment. Mayo Clin Proc. 2005;80(7):908–16. https://doi.org/10.4065/80.7.908.

    Article  PubMed  Google Scholar 

  9. Jones NS. Sinus headaches: avoiding over- and mis-diagnosis. Expert Rev Neurother. 2009;9(4):439–44. https://doi.org/10.1586/ern.09.8.

    Article  PubMed  Google Scholar 

  10. Foroughipour M, Sharifian SM, Shoeibi A, Ebdali Barabad N, Bakhshaee M. Causes of headache in patients with a primary diagnosis of sinus headache. Eur Arch Otorhinolaryngol. 2011;268(11):1593–6. https://doi.org/10.1007/s00405-011-1643-6.

    Article  PubMed  Google Scholar 

  11. Ozge A, Abu-Arafeh I, Gelfand AA, Goadsby PJ, Cuvellier JC, Valeriani M, et al. Experts' opinion about the pediatric secondary headaches diagnostic criteria of the ICHD-3 beta. J Headache Pain. 2017;18(1):113. https://doi.org/10.1186/s10194-017-0819-x.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Wald ER, Applegate KE, Bordley C, Darrow DH, Glode MP, Marcy SM, et al. Clinical practice guideline for the diagnosis and management of acute bacterial sinusitis in children aged 1 to 18 years. Pediatrics. 2013;132(1):e262–80. https://doi.org/10.1542/peds.2013-1071.

    Article  PubMed  Google Scholar 

  13. Rosenfeld RM, Piccirillo JF, Chandrasekhar SS, Brook I, Ashok Kumar K, Kramper M, et al. Clinical practice guideline (update): adult sinusitis. Otolaryngol Head Neck Surg. 2015;152(2 Suppl):S1–S39. https://doi.org/10.1177/0194599815572097.

    Article  PubMed  Google Scholar 

  14. Barbanti P, Fabbrini G, Pesare M, Vanacore N, Cerbo R. Unilateral cranial autonomic symptoms in migraine. Cephalalgia. 2002;22(4):256–9. https://doi.org/10.1046/j.1468-2982.2002.00358.x.

    CAS  Article  PubMed  Google Scholar 

  15. • Gelfand AA, Reider AC, Goadsby PJ. Cranial autonomic symptoms in pediatric migraine are the rule, not the exception. Neurology. 2013;81(5):431–6. https://doi.org/10.1212/WNL.0b013e31829d872aCranial autonomic symptoms in pediatric patients.

    Article  PubMed  PubMed Central  Google Scholar 

  16. • Raieli V, Giordano G, Spitaleri C, Consolo F, Buffa D, Santangelo G, et al. Migraine and cranial autonomic symptoms in children and adolescents: a clinical study. J Child Neurol. 2015;30(2):182–6. https://doi.org/10.1177/0883073814535494Cranial autonomic symptoms in pediatric patients.

    CAS  Article  PubMed  Google Scholar 

  17. May A, Goadsby PJ. The trigeminovascular system in humans: pathophysiologic implications for primary headache syndromes of the neural influences on the cerebral circulation. J Cereb Blood Flow Metab. 1999;19(2):115–27. https://doi.org/10.1097/00004647-199902000-00001.

    CAS  Article  PubMed  Google Scholar 

  18. Lipton RB, Stewart WF, Liberman JN. Self-awareness of migraine: interpreting the labels that headache sufferers apply to their headaches. Neurology. 2002;58(9 Suppl 6):S21–6. https://doi.org/10.1212/wnl.58.9_suppl_6.s21.

    Article  PubMed  Google Scholar 

  19. • Swain SK, Sahu MC, Samantray K. An unusual cause of otalgia in a child—a case report. Pediatr Pol. 2016;91:480–3 Case report of pediatric rhinogenic contact point headache.

    Article  Google Scholar 

  20. • Kim SH. A case of nasal septal deviation-induced rhinogenic contact point otalgia. Am J Otolaryngol. 2015;36(3):451–5. https://doi.org/10.1016/j.amjoto.2015.01.008Case report of pediatric rhinogenic contact point headache.

    CAS  Article  PubMed  Google Scholar 

  21. • Mishra D, Choudhury KK, Gupta A. Headache with autonomic features in a child: cluster headache or contact-point headache? Headache. 2008;48(3):473–5. https://doi.org/10.1111/j.1526-4610.2007.01028.xCase report of pediatric rhinogenic contact point headache.

    Article  PubMed  Google Scholar 

  22. Clerico DM. Pneumatized superior turbinate as a cause of referred migraine headache. Laryngoscope. 1996;106(7):874–9. https://doi.org/10.1097/00005537-199607000-00017.

    CAS  Article  PubMed  Google Scholar 

  23. Parsons DS, Batra PS. Functional endoscopic sinus surgical outcomes for contact point headaches. Laryngoscope. 1998;108(5):696–702. https://doi.org/10.1097/00005537-199805000-00013.

    CAS  Article  PubMed  Google Scholar 

  24. Wang J, Yin J-S, Peng H. Investigation of diagnosis and surgical treatment of mucosal contact point headache. Ear Nose Throat J. 2016;95:E39–44.

    Article  Google Scholar 

  25. Eyigor H, Eyigor M, Erol B, Selcuk OT, Renda L, Yilmaz MD, et al. Changes in substance P levels of inferior turbinate in patients with mucosal contact headache. Braz J Otorhinolaryngol. 2019. https://doi.org/10.1016/j.bjorl.2019.01.006.

Download references

Author information

Authors and Affiliations

  1. Department of Otolaryngology – Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA

    Gregory L. Barinsky

  2. Department of Otolaryngology – Head and Neck Surgery, University of Minnesota, Minneapolis, MN, USA

    Curtis Hanba

  3. Hackensack University Medical Center, Hackensack, NJ, USA

    Peter F. Svider

Authors
  1. Gregory L. Barinsky
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Curtis Hanba
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Peter F. Svider
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Peter F. Svider.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Childhood and Adolescent Headache

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Barinsky, G.L., Hanba, C. & Svider, P.F. Rhinogenic Headache in Children and Adolescents. Curr Pain Headache Rep 24, 7 (2020). https://doi.org/10.1007/s11916-020-0839-0

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11916-020-0839-0

Keywords

  • Rhinogenic headache
  • Sinus headache
  • Mucosal contact point headache
  • Pediatric headache