Headache is one of the symptoms that significantly affect our daily life and quality of life and disturbs our concentration, stamina and inevitably our performance.
When it is frequent, it creates a concern that there may be something serious going on in our heads, and this concern is often compounded by unreliable information on the internet. The only sure way to find a solution to our problem is to go to the doctor.
As Dr. Anatoli Pataridou, MD, an otolaryngologist, head and neck surgeon, scientific associate of the Health Hospital (www.pataridou.gr ) explains., headaches are generally caused by problems such as blood pressure disorders that need to be monitored, weight gain that also affects the spine, psychological causes (especially stress), migraine, substance abuse such as alcohol and coffee, and lack of exercise.
«It is particularly important to ask the patient about the intensity of the pain, its duration, location, frequency, association with certain conditions, and whether they have noticed that something is causing or worsening their pain,» he says.
Allergic Rhinitis and Sinusitis
The nose is an organ that is closely related to headaches, although most people don't think about it. In people with frequent headaches, a thorough examination of the nose by an otolaryngologist is essential.
With the help of endoscopes, this check often reveals a crooked septum that presses nerve endings and leads to pain, polyps in the nose, acute or chronic sinusitis, allergic rhinitis or even benign or malignant tumours of the nose.
A typical case is that of sphenoiditis or «sneaky» sinusitis. This manifests with symptoms such as headache (usually behind the eyes), congestion, posterior nasal discharge, decretory febrile movement, prolonged history of atypical symptoms (such as malaise, atony, instability), recurrent upper respiratory infections, visual disturbances and other neurological disorders, according to Dr. Pataridou.
«Unfortunately, because the atypical symptoms are often not properly assessed, the patient ends up with complications such as brain abscess or meningitis, as well as eye complications,» he adds.
Obstructive Sleep Apnea
Another common cause of headache is obstructive sleep apnea syndrome, which causes poor oxygenation of the brain and leads to headache and fatigue. These patients should be carefully examined endoscopically and, if there are anatomical problems blocking the nose, pharynx or larynx, surgically corrected.
Other Causes
Dryness of the nose which may be due to hormonal causes, environmental influence, season, exposure to irritants such as odors, chemicals, air conditioning, etc., also often causes headaches. So does arthritis of the temporomandibular joint, which can be caused by orthodontic problems, teeth grinding at night while sleeping (bruxism), bad chewing habits or dentures.
Otitis media
Ear conditions that can cause headaches are acute otitis media (otitis externa or otitis media), chronic otitis, and otic shingles.
Ear infections usually occur with pain in the ear, rather than pain in the head.
Similarly, otic shingles is a viral inflammation that mainly affects the facial nerve (responsible for facial movements) but can also affect the auditory nerve (responsible for hearing and balance). Patients affected by this virus experience severe neuralgic pains in the ear and temple.
Tumours of the Throat - Throat
Reflex pain in the head region can be caused by the presence of a tumour in the throat and even in the tonsil. Headache is seen in 20% of people with nasopharyngeal cancer. The nasopharynx is the upper part of the pharynx located behind the nose.
Tumours in the nasopharynx are extremely rare (0.2% of all cancers) and usually manifest with cervical lymph node enlargement (in 50% of cases.) Other symptoms may include nasal congestion, nosebleeds, secretory otitis media. Even hypopharyngeal cancer in advanced stages can cause headache.
Diagnosis and Treatment
The use of endoscopes brought a revolution in otolaryngology and gave a boost to both the diagnostic evaluation that is now done using rigid and flexible endoscopes, with imaging methods (CT, MRI) and culture taking, endoscopically and surgical treatment. Initial treatment includes antibiotics and decongestive treatment with lavage, topical sprays, steroids and antihistamines.
Surgical treatment is indicated if the patient does not respond to medication and is necessary for both diagnostic and therapeutic reasons.
In any case, when the headache comes often and persists it should be checked. So before we attribute it to stress, it is necessary to exclude any organic cause and this often requires testing by several specialists. The position of the otolaryngologist is very basic to clarify if there is any pathology that needs treatment by medication or surgery.
