Rhinogenic Headache: The Dehiscence of Infraorbital Nerve

J Craniofac Surg. 2024 Apr 26. doi: 10.1097/SCS.0000000000010124. Online ahead of print.

Abstract

Rhinogenic headache (RH), arising from nasal and sinus pathologies, present a diagnostic challenge due to their diverse etiologies. This study investigates a unique case where RH coincides with infraorbital nerve dehiscence, delving into the intricate relationship between sinonasal anatomy and neurovascular complications. The infraorbital nerve contacted a cyst in the maxillary sinus. Centripetal endoscopic sinus surgery was performed to open the maxillary sinus and remove the cyst. After 3 months of follow-up, the patient had a notable improvement in symptoms with a reduced headache. This case highlights the significance of considering uncommon anatomic variations, such as infraorbital nerve dehiscence, within the context of RH. Diligent history-taking and appropriate use of radiologic investigations are pivotal for guiding clinicians toward an accurate diagnosis and determining the most appropriate course of treatment.