Can we Avoid Pointless Procedures for Sinus Congestion?

Researchers continue to express concern about incorrect diagnosing of sinus congestion. And the situation is more serious than you may think, because patients continue to take medications and undergo tests that may not be necessary.

A recent article in The American Journal of Otolaryngology again points out some of these issues. (By the way, otolaryngology, believe it or not, is an abbreviation of otorhinolaryngology, which refers to treatment related to the ears, nose, throat, head and neck.)

The article is about the treatment of rhinosinusitis, also known as sinusitis. The authors state: “Treatment of rhinosinusitis (RS) is one of the leading reasons for prescriptions of antibiotics, although they often fail to provide symptomatic relief.” (see abstract: Update on the diagnostic considerations for neurogenic nasal and sinus symptoms: A current review suggests adding a possible diagnosis of migraine)

Our modern concerns about the use of antibiotics aside, we should already know that something is wrong when they often don’t even alleviate the symptoms.

Previous research has suggested that most of the time the diagnosis of sinusitis is wrong, and that the culprit is actually migraine. The report clarifies this in further technical detail:

One explanation is that … Midfacial pain and pressure with rhinorrhea and nasal congestion do not represent an infectious, or even inflammatory, condition within the sinus or nasal cavities, but a mirage that is best treated as a migraine variant.

Notice the symptoms that could be from a migraine attack:

• midfacial pain (sometimes referred to as “midface migraine”)
• midfacial pressure
• rhinorrhea (nasal cavities full of mucus, aka runny nose)
• nasal congestion

These are not uncommon migraine symptoms.

To make matters worse, many patients who do not find relief with antibiotics also submit to a CT scan – radiation which increases their risk of cancer.

To add to the challenge yet again, patients often come to doctors insisting that they have sinusitis. As the researchers affirm in this report, doctors should seriously consider asking more questions before prescribing drugs that won’t help (this includes not only antibiotics but also nasal sprays) or scans that aren’t necessary.

If you’re feeling congested and have a headache, take a closer look at your symptoms.

For quick information to share with a friend, see Sinus Headache – Probably Migraine.