Differences between chronic rhinitis, sinusitis and nasopharyngeal carcinoma headaches

Nasopharyngeal carcinoma ranks first in the incidence of head and neck malignant tumors. In severe cases, it can cause severe headaches. Chronic rhinitis and sinusitis are common diseases in life and can also cause splitting headaches and extreme discomfort. So, what are the differences in the headache symptoms of the three?

Chronic rhinitis

Chronic rhinitis refers to inflammation under the nasal mucosa that persists for more than several months, or repeated inflammation that does not return to normal during the intervals, and there is no obvious infection with pathogenic microorganisms.

Headache is caused by poor nasal ventilation and blockage, mostly dull pain, or bloating in the forehead, with a feeling of tightness and no pulsation. It is heavier during the day and relieved when lying in bed. The headache worsens when the nasal mucosa is congested.

Chronic sinusitis

Chronic sinusitis causes headaches in 53% of patients. Coughing, lowering the head, or exerting force will aggravate the headache due to increased venous pressure in the head. Smoking, drinking, and emotional agitation will also aggravate the headache. The headache of maxillary sinusitis is characterized by persistent dull pain, located on the temporal side, which is lighter in the morning and heavier in the afternoon. The headache can be relieved by natural drainage during sleep. The headache of frontal sinusitis is located in the patient's upper eye socket and forehead. The headache is more severe at noon, relieved at 3 to 4 pm, and disappears naturally at night. In the anterior group of ethmoid sinusitis, the headache is in the forehead, between the eyebrows, or between the inner eye socket and the root of the nose; in the posterior group of ethmoid sinusitis, the headache is mainly on the top of the head and behind the eyeball.

Nasopharyngeal carcinoma

When nasopharyngeal carcinoma metastasizes to the skull base and invades the meninges and the second and third branches of the trigeminal nerve, the patient will experience cheek pain on one side and persistent headaches that cannot be relieved. The headache may suddenly worsen on the basis of chronic headaches, often accompanied by nasal congestion, epistaxis, and conductive deafness (caused by cancer blocking the Eustachian tube). Physical examination shows paralysis of most cranial nerves, especially the involvement of the trigeminal nerve, swollen and hard lymph nodes in the neck, bone destruction can be seen in CT and MRI of the nasopharynx and skull base, and biopsy of the swollen lymph nodes and nasopharynx can confirm the diagnosis.