Headaches are common and can have a wide range of causes, which include chronic sinusitis. A recent study form the University of Wisconsin reports that 85% of patients who underwent functional nasal surgery had at least partial improvement in their headaches (Plast Reconstr Surg. 2018; 142:1583-1592). 1,577 patients who underwent functional nasal surgery for treatment of headaches due to intranasal mucosal contact points were evaluated. The most common procedures were surgery to correct a deviated nasal septum, and endoscopic sinus surgery.
The data indicated that functional nasal surgery was highly effective in reducing or eliminating chronic headache symptoms. Nearly 48% of patients reported that their headaches resolved after surgery, while another 37% had improvement in headache severity or frequency. Only 15% of patients reported no change in their headache symptoms. Outcomes appeared better when endoscopic sinus surgery was performed with correction of a deviated nasal septum(septoplasty).
Anecdotally, I recently saw a physician I operated on several years ago who had severe sinus disease. He had a history of migraine associated with visual aura prior to his surgery which was not controlled by medical treatment. He states that since his operation(endoscopic sinus surgery and septoplasty), he no longer has headaches, migraine or otherwise.
While there are numerous causes and treatments for chronic headaches, chronic sinusitis and/or nasal obstruction should be considered in the evaluation and treatment of headaches.
