A review of how the Texas Sinus Center evaluates and treats patients with sinus pain/headache.

1. Sinus Headaches

2. Symptoms
• Most patients have symptoms of:
– Cheek and/or forehead pain
– Pain behind the eyes

3. Symptoms
• The pain can be constant or associated
with:
– Sinus infections
– Cold fronts
– Allergy flare ups

4. Causes
• Not all sinus pain comes from sinus
problems.
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5. Causes
• Other problems that can cause sinus
pain are:
– Migraines that only affect the sinuses
– Neck problems that radiate pain to
the sinuses
– Temporo-Mandibular Disorders (TMD,
also called TMJ)
– Dental problems
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6. Evaluation
• Our job is to determine if your
symptoms are coming from your
sinuses.
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7. Evaluation
• We do that with three tests.
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8. Evaluation – CT Scan of Sinuses
• Done in our office
• Takes 40 seconds to scan and 5
minutes to get results
• Low radiation dose. Only 1/10th the
radiation of a full CT scan
• Looks for infection or polyps or
blockage
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9. Evaluation – Nasal Endoscopy
• Looking in your nose with a
telescope tells us if you have
excessive inflammation, polyps or a
septal deviation.
• It is painless and takes a couple of
minutes.
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10. Evaluation – Allergy Testing
• We test for allergies in our office.
• It takes about 30 minutes and is
painless.
• We usually combine this with a CT
of your sinuses on the same day to
save you time.
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11. Treatment if it is a Sinus Problem
• Infection is treated with antibiotics
and sometimes surgery.
• Allergies are treated with
medications and sometimes allergy
shots.
• Blockage of the nose or sinuses
usually requires surgery.
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12. What if it is Not a Sinus Problem
• If we don’t find a sinus problem we
question and examine you for
other causes of your sinus pain.
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13. Migraine
• Most patients with facial pain don’t
think they have migraines because
they may not have classic severe
headaches with nausea
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14. Migraine
• There is a version of migraines that
can cause sinus pain without a
major headache or nausea.
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15. Migraine
• If we think you have a migraine we
will refer you to a specialist that
has an interest in migraines We use
them frequently and get good
results.
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16. Neck Problems
• Patients can have neck problems
from an accident or something as
little as the way they sit at work.
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17. Neck Problems
• We have specialists we refer to that
are experts at this problem and
have helped a lot of our patients.
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18. TMD or TMJ (same thing)
• This is an inflammation of the jaw
joint and it can cause pain to be
referred to the face.
• We also work with specialists in
this area and will refer you if
needed.
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19. Dental Problems
• Tooth pain referred to the face is
most common on one side or the
other.
• We look for this cause and work
with your dentist to help get a
dental cause treated.
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20. Surgery
• If surgery is needed we try and do
balloon sinus dilation in the office.
• This is done under local anesthesia
and is minimally invasive.
• More severe infections and severe
blockage have to be fixed in the
operating room.
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21. Links
• The following link takes you to
YouTube where you can see videos
of some of the diagnostic
procedures and surgeries that we
do.
• http://www.youtube.com/texassinusce
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