Sinus headaches are a common complaint from patients and primary care physicians are often the first providers they turn to for help. But without the proper tools, like nasal endoscopy and point-of-care CT scans, it can be difficult to diagnose whether the headache is from sinusitis or another cause — rhinogenic and non-rhinogenic headaches can have similar or overlapping symptoms.
Several key studies, including the landmark Sinus, Allergy, and Migraine Study, highlight the tendency to incorrectly diagnose and treat the majority of sinus headaches as sinusitis, leading to antibiotic overuse, unnecessary surgical interventions, and continued suffering.
To enable more accurate diagnoses and effective, cost-efficient care, the clinical research team in Duke Head and Neck Surgery & Communication Science’s Division of Rhinology and Endoscopic Skull Base Surgery is creating a validated sinus symptom screening questionnaire to differentiate sinusitis from non-rhinogenic facial pain or pressure.
The project stemmed from a partnership between Duke and Rick Godley, MD, president of the Association of Migraine Disorders (AMD). AMD, a leading organization in educating clinicians and patients on the importance of migraine in otolaryngology, provided funding for the project.
“Dr. Godley was an early collaborator of Dr. David Witsell, who investigated migraine in otolaryngology through his National Institutes of Health CHEER grant,” David Jang, MD, co-principal investigator of the questionnaire project, explains. “They’ve done important work in characterizing migraine in the otolaryngology setting.”
The next logical step was to help clinicians diagnose migraines and other non-rhinogenic headache conditions and differentiate them from sinusitis, illuminating the need for a screening questionnaire.
The research team also includes co-principal investigator Theresa Coles, PhD, health outcomes methodologist at Duke’s Center for Health Measurement within the Department of Population Health Sciences. “Dr. Coles is an expert in developing patient-reported outcomes measures and screening questionnaires,” says Dr. Jang.
The questionnaire is currently being validated in the clinical setting; data collection slated for completion in December will drive further refinements. Ultimately, the goal is to put it to use in the primary care setting, where millions of Americans are seen for sinus headaches each year.
For more information about the study, contact the clinical research program within the Division of Rhinology.