A headache is not always caused by “stress” or fatigue. Quite often its source lies in the ENT area: the sinuses, nose, ears, or nasopharynx. It is important to distinguish a typical tension headache or migraine from one associated with sinus inflammation or pressure changes in the ears, and to understand when consultation with an otolaryngologist is needed.
When a Headache Is Related to ENT Organs
Certain symptoms suggest that the root of the problem is in the nose or ears. The main goal of today’s article is to help you distinguish a common headache from a more serious condition.
Sinusitis (Sinus Inflammation)
Typical signs of sinusitis include pressure or pain in the cheeks, forehead, or around the roots of the teeth, nasal congestion, thick discharge, reduced sense of smell, and sometimes fever. If symptoms last more than 7–10 days, worsen after temporary improvement, recur frequently, or are very intense, you should see a doctor. In cases of frequent episodes, a primary care physician will refer you to an ENT specialist.
Eustachian Tube Dysfunction and Barotrauma
Dysfunction of the Eustachian tubes causes a feeling of fullness, “noise”, or pain in the ear and may provoke headaches—especially after flights, diving, or against the background of a cold or allergies. An ENT doctor will assess the eardrums, tube patency, and select therapy; conservative treatment is often sufficient, but persistent symptoms require medical management.
“Sinus Headache” or Migraine?
Up to 90% of patients convinced they have a “sinus headache” actually suffer from migraine: congestion, tearing, light sensitivity, and pressure in the sinus area may also occur in migraines. If decongestants and “nasal sprays” do not help, a differential diagnosis is required—sometimes by an ENT together with a neurologist.
Red Flags: When Urgent Care Is Needed
There are warning signs that do not allow waiting for a scheduled visit—emergency care is required. These “red flags” include:
- Suddenly, unbearable headache reaching peak intensity within minutes.
- Headache with fever and widespread rash, often accompanied by confusion.
- Neurological symptoms: limb weakness, facial asymmetry, speech disturbance, double vision.
- Worsening vision or atypical eye pain.
A new or unusual headache in older adults, during pregnancy, or in people with cancer or immunodeficiency
Such conditions require urgent diagnostics, as they may indicate subarachnoid hemorrhage, CNS infections, or other dangerous causes.
How an ENT Specialist Can Help
If you suspect an ENT-related cause of headache, contacting a specialist at North Fulton Ear Nose & Throat will speed up the path to relief. The doctor will perform a number of important steps to detect and manage the condition at an early stage.
Diagnostics
The doctor takes medical history, examines the nose and nasopharynx (anterior/posterior rhinos copy, endoscopy), and assesses the eardrums and Eustachian tube patency. If needed, a CT scan of the sinuses or audiometry may be ordered to clarify the cause and rule out complications.
Conservative Treatment
For viral sinusitis, symptomatic therapy is usually sufficient: saline irrigation, intranasal steroids for allergies, short courses of decongestants, NSAIDs; antibiotics are prescribed only in cases of bacterial infection (longer duration, high fever, pronounced localized pain, purulent discharge). For Eustachian tube dysfunction — pressure equalization techniques, treatment of rhinitis/allergies; other methods if needed.
Prevention and When to Return for Follow-Up
Air humidification, adequate hydration, allergy control, smoking cessation, and proper nasal hygiene reduce the risk of flare-ups. You should return to the doctor if symptoms persist for more than 3 weeks, recur frequently, or are complicated by ear pain, severe congestion, hearing loss, or fever. In cases of recurrence, additional testing or surgical options may be offered if indicated.