Otorhinolaryngologist Dr. Ahmad Hafiz Ali Tackles ENT-Related Headache Causes

Worldwide, at least 40% of people suffer from tension headaches, while 10% battle migraines daily. Where severe and persistent, the situation may well prove debilitating. These disrupt the daily functions and many take for granted. Still, what do said issues have to do with otorhinolaryngology (ear, throat, and nose field) and how do ENT specialists treat headaches? Dr. Ahmad Hafiz has insights to offer. 

Issues like sinusitis, nerve damage (ear, nose, and throat), or a deviated septum can cause headaches.  

DIAGNOSING HEADACHE TRIGGERS

Generally, headaches fall under two main classifications: primary and secondary. Primary headaches are the most common type of headaches. Examples include tension headaches, cluster headaches, and migraines.  These, however, aren’t due to any pre-existing medical condition. Meanwhile, secondary headaches are caused by an underlying problem such as a head injury or an infection and are attended to differently.  So, how to distinguish between the two types when a patient comes in for a consult? An ENT (ear, nose, and throat) doctor is a good place to start. Also known as otorhinolaryngologists, these specialists run targeted tests to create a clear distinction to ensure patients receive the right treatment.  

Establishing The Crucial Connection

Otorhinolaryngologists are healthcare experts which help differentiate between primary and secondary headaches. When linked to ENT issues, treatment could entail such alternatives as nasal decongestants, allergy medications, or antibiotics. With deviated septums and other structural challenges, corrective surgery may be the best route. For migraine management, on the other hand, an otorhinolaryngologist sometimes collaborates with a neurologist or other specialists. In some cases, an otorhinolaryngologist may turn to targeted botulinum toxin injections or similar therapies to address the key trigger points associated with migraines. Importantly, headaches aren’t always critical or simply stress-related either. 

“Otorhinolaryngologists play a truly significant role in diagnosing and treating headaches—in particular, those related to ear, nose, and throat dilemmas. These specialists identify and address conditions like sinusitis, deviated septums, ear infections, and nerve problems in the ear, nose, and throat, and other areas which contribute to or trigger headaches. Otorhinolaryngologists are also key to recognising and managing migraines, especially since these can be misdiagnosed  as sinus headaches. Headaches could definitely be a symptom of an underlying ENT problem,” says resident consultant otorhinolaryngologist and head and neck surgeon at Putra Medical Centre, Dr. Ahmad Hafiz Ali.

ENT doctors use several methods like a detailed patient history and physical examination, and others. 

Professional Treatment Approaches

Otorhinolaryngologists are often the first point of contact for those experiencing headaches, especially those with ear, nose, and throat complaints. They understand that certain ailments like sinusitis can trigger headaches. Conversely, headaches may be a symptom of ENT problems. A firm understanding of the interplay between these and headaches is crucial for an accurate diagnosis and treatment. ENTs use a few methods like a detailed patient history and physical examination. Another is a nasal endoscopy to view nasal passages and identify potential issues like mucosal contact points. Meanwhile, imaging studies like CT scans help assess the sinuses or other key structures in the ear, throat, and nose region.  

Over-the-counter pain relievers like ibuprofen and acetaminophen tackle mild to moderate headaches.  Meanwhile, prescription medications such as triptans ease severe migraines. Lifestyle changes like stress management and adequate sleep could prove helpful. Due to the complexity of headache management, however, otorhinolaryngologists often collaborate with neurologists, ophthalmologists, or psychiatrists to ensure that a patient is afforded comprehensive care. This multidisciplinary route ensures potential causes of a headache are addressed and a person in pain is given the most effective treatment plan.  ENTs do bear the responsibility of first ruling out the possibility of a deeper root cause.

Conditions With An ENT Correlation

“The treatment for certain conditions depends on the diagnosis from your otorhinolaryngologist. Even if the symptom is a headache, your medical solution will be based on that diagnosis specific to you.  To understand how fixing a headache may call for the expertise of an ear, nose, and throat specialist, a window view into such ailments could enable a more informed grasp where the layperson is concerned,” adds Dr. Hafiz. The good doctor dives into a few health-related challenges which beg consideration.  The list below offers useful information and could point someone in the right direction, especially if they’ve been searching for answers to questions regarding their dilemma of being in pain.

• Deviated Septum : Whether congenital (from birth) or resulting from trauma, a deviated septum is when the wall between one’s nostril passages is asymmetrical, deviating either to the left or right. The condition could worsen, with age or a fresh injury being factors. A pre-existing condition is exacerbated by a narrowing of one of the passages, which is a prime reason surgery is often the proposed long-term solution to this ongoing hurdle, particularly where headaches are a main feature. While medications offer temporary relief, the underlying cause must be dealt with for a more permanent resolution. An ENT will walk you through it.

• Ear Infections : These affect the inner, outer, and middle ear, and lead to headaches, or even migraines in severe cases.  Upon inspecting the inside of one’s eye to locate the cause, an ENT specialist may prescribe antibiotics, depending on the severity of the problem. A doctor may recommend specific ear drops, decongestants, or pain relief remedies to manage any additional symptoms, like the recurring or severe headaches.

• Nerve Damage : With recurring headaches, another possibility is damage to the nerves in the ear, nose, or throat. Where any of these nerves might be pinched or trapped, pain in the same region is a telltale sign. For instance, when the glossopharyngeal nerve situated in the throat is infected (sometimes from a previous surgery), the irritation which emerges takes on the form of an intense headache, or pain in the throat or even ear.  The condition is called glossopharyngeal neuralgia. Pressure can be eased with pain relief or a procedure.

• Sinusitis : The sinuses are located around the cheekbones and forehead. Sinusitis is an infection of the mucosa surrounding the sinuses, causing swelling, facial pain, and tension in the affected areas due to blockages.  Combined, these often manifest in the form of a headache. Acute sinusitis is when these symptoms last under four weeks, while chronic sinusitis is when the problem persists even after a whole month passes.  Allergies and other structural discrepancies can trigger a flare-up. Treatment options cover nasal sprays, corticosteroids (for inflammation), decongestants, and over-the-counter pain relief meds like ibuprofen.

ABOUT DR. AHMAD HAFIZ

A resident consultant otorhinolaryngologist and head and neck surgeon at Putra Medical Centre Dr. Ahmad Hafiz specialised in ENT-specific treatments such as nasal bone fracture reductions, cancer screening (ear, nose, and throat scopes), endoscopic nasal and sinus surgery, ear wax and fungal cleaning, endoscopic nasolacrimal duct surgery, sinusitis, tonsil and adenoid surgery, voice and vocal cord surgery, allergy rhinitis, epiphora, snoring, tracheostomy care, and more. He completed his Master of Medicine in Otorhinolaryngology–Head and Neck Surgery at Universiti Sains Malaysia (MY). He obtained his Bachelor of Medicine, Bachelor of Surgery, and Bachelor of Obstetrics from the Royal College of Surgeons in Ireland (IE). He pursued his postgraduate clinical training at Raja Perempuan Zainab II Hospital and Universiti Sains Malaysia Hospital.

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