From January 1, 1991, to June 30, 1992, 18 patients were identified as
having rhinologic sources for their primary symptom of facial pain or
headache. These 18 patients satisfied certain inclusion and exclusion
criteria to identify the site of origin of the headaches or facial pa
ins as coming from the nasal cavities or paranasal sinuses. The majori
ty of these patients (12 patients) were determined to have a septal sp
ur causing the facial pain or headache. Other identified causes includ
ed retention cysts (3 patients), mucosal contact points (2 patients),
and a dehiscent infraorbital nerve (1 patient). Fifteen of these 18 pa
tients (83%) were significantly improved or cured of their facial pain
or headache after medical or surgical therapy. The 3 patients who had
either a minimal improvement or no improvement in their facial pains
or headaches included I patient with an area of mucosal contact betwee
n the middle turbinate and the bulla ethmoidalis and 2 patients with s
eptal spurs. In summary, medical or surgical therapy can be beneficial
in the treatment of patients with headaches or facial pains of rhinol
ogic origin.