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BackTable / ENT / Podcast / Episode #228
Sinus Headaches vs. Migraines: Diagnosis & Treatment
with Dr. Jessica Lee
Sinusitis or migraine? Understanding the difference between rhinogenic and primary headaches could change your treatment algorithm. In this episode of Backtable ENT, Dr. Jessica Lee, an otolaryngologist from Charleston ENT and Allergy, discusses the prevalence and treatment of sinus headaches with hosts Dr. Gopi Shah and Dr. Ashley Agan.
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BackTable, LLC (Producer). (2025, June 24). Ep. 228 – Sinus Headaches vs. Migraines: Diagnosis & Treatment [Audio podcast]. Retrieved from https://www.backtable.com
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Synopsis
The doctors discuss how half of sinus infection diagnoses are often misdiagnosed, with many patients having normal CT scans and nasal endoscopies. Dr. Lee emphasizes the importance of distinguishing between sinus-related headaches and migraines, noting that 80% of sinus headache complaints meet migraine criteria. The conversation covers the use of lifestyle medicine, supplements, medications, and the role of neurologists in managing chronic headaches. Dr. Lee also touches on the role of mycotoxins, drawing from evidence-based practices while stressing patient education and collaboration in treatment.
Timestamps
00:00 - Introduction
04:10 - Differentiating Sinus Headaches from Other Conditions
10:07 - Lifestyle Factors and Migraine Management
25:45 - Supplements and Treatments for Migraine
30:01 - Iron Supplementation and Dietary Adjustments
31:42 - Medication Management for Migraines
34:52 - Botox as a Treatment Option
44:50 - Mycotoxins and Mold Illness
50:11 - Non-Pharmacologic Options for Headaches
54:00 - Final Thoughts and Recommendations
Resources
Dr. Jessica Lee
https://charlestonent.com/bio/jessica-lee/
Transcript Preview
[Dr. Jessica Lee]
I would recommend that before someone goes to an urgent care the next time for the same "sinus infection symptoms," that they just stop and think, "Could this be something else?" You can Google search the criteria and the recommended guidelines from EPOS. If you don't match with those sinus symptoms guidelines, consider that this could be an alternate diagnosis. Then think about the benefit of actually getting to the root of the problem and treating it versus not only being misdiagnosed, but also mistreated because we know that there's harms with repetitive, unnecessary antibiotic courses and steroids for that matter.
My ending thing is remember that final statistic as we leave, that 80% of sinus headaches meet migraine criteria, and have this conversation with your provider about this possibility, because there's a lot of other diagnostics and treatment options out there that can help you get answers. Then that's going to give you the long-lasting relief that you're really looking for.
The Materials available on BackTable are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.
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