Abstract

Background: Headache is most common complaint of human being. Classified into primary (migraine, tension headache and trigeminal neuralgia) and secondary (infectious, vascular and drug induced). Sinugenic headache is deep seated, dull aching with fullness and heaviness in sinus area. The purpose of study to assess the comprehensive role of otorhinolaryngologists in the diagnosis of headache and to evaluate the efficacy of medical and surgical management of patients presented with headache. 200 patients reported to rhinology clinic with headache. Detailed history, head and neck examination routine blood investigation, fundus examination and anterior rhinoscopy, radiological investigations X-ray paranasal sinuses, skull and cervical spine and direct nasal endoscopy was and CT paranasal sinus preoperatively done

Results: 200 patients assessed using VAS analog scale before and after treatment dividing into four groups: resolved, improved, no change, and worsened’ group; p value was statistically significant in resolved and improved group whereas non-significant in no change and worsened group. 129 patients had non-sinugenic headache; 29(22.48%) with cervical cause, Migraine 24 (18.60%) and ophthalmic 23 (17.48%) respectively; dental and vascular 19 (14.72%) each, and psychogenic headache in 13 (10.07%) and trigeminal neuralgia in 2 patients (1.55%). 96.12% were relieved by medical treatment whereas 71 patients of sinugenic headache 21.12% were treated successfully with medical treatment. One refused surgery, 50/55 (90.90%). Improvement assessed by SNOTT-22 pre and post-surgery that was statistically significant p value-0.002.

Conclusion: Headache need comprehensive management. Sinugenic headache managed successfully initially with medical treatment and refractory cases by surgical intervention with equal efficacy.

Keywords: Sinugenic Headache; Otorhinolaryngologists; SNOTT-22; Contact Point Headache

References

1. Belamkar SK and Tugave J. “The usefulness of nasal endoscopy in diagnosing and managing sinugenic headache”. Medpulse International Journal of ENT 4 (2017): 45-48.
2. Martin V and Elkind A. “Diagnosis and classification of Primary Headache disorders”. In Standards of care for headache diagnosis and treatment. Chicogo (II): National Headache Foundation (2004): 4-18.
3. Ahmad Z., et al. “Headache and Sinus Disease. A Clinical Study”. International Journal of Remote Sensing 6 (2018).
4. Cady RK., et al. “Sinus headache: A neurology, otolaryngology, allergy, and primary consensus on diagnosis and treatment”. Mayo Clinic Proceedings 80 (2005): 908-916.
5. “Headache Classification Committee of the International Headache Society”. International Classification of Headache Disorders (2nd Edition). Cephalgia 24 (2004): 1-151.
6. Grylas A. “Allergic rhinitis and chronic daily headache: is there a link?” Current Neurology and Neuroscience Reports 16 (2016): 33.
7. Hopkins C., et al. “Psychometric validity of the 22-item Sinonasal Outcome Test”. Clinical Otolaryngology 34 (2009): 447-454.
8. West B and Jones NS. “Endoscopy-negative, computed tomography negative facial pain in a nasal clinic". Laryngoscope 111 (2001): 581-586.
9. Hirose Y., et al. “Acute sphenoiditis involving the second branch of trigeminal nerve”. QJM 109 (2016): 745-746.
10. Cantone E., et al. “Concha bullosa related headache disability”. European Review for Medical and Pharmacological Sciences 19 (2015): 2327-2330.
11. La Mantia I., et al. “Rhinogenic contact point headache: surgical treatment versus medical treatment”. Journal of Craniofacial Surgery 29 (2017): 228-230.
12. Foroughipour M., et al. “Causes of sinus headache in patients with a primary diagnosis of sinus headache”. European Archives of Otorhinolaryngology 268 (2011): 1593-1596.
13. Eross E., et al. “The sinus, Allergy and Migraine Study (SMAS)”. Headache 47 (2007): 213-224.
14. Kumar KS and Devan PP. “Do you really have sinus headache?” International Journal of Otorhinolaryngology and Head and Neck Surgery 5 (2019): 554-559.
15. Chakraborty D., et al. “A clinical study of headache in relation to chronic rhinosinusitis”. Scholars Journal of Applied Medical Sciences 6 (2018): 3718-3721.
16. Kumar P and Chawla P. “A correlative study of sinusitis versus headache”. Indian Journal of Otolaryngology and Head and Neck Surgery 52 (2000): 125-127.
17. Jee HW., et al. “Prospective Study on the Characteristics and Postoperative Improvement of Rhinogenic Headache”. Journal of Rhinology 22 (2015): 6-10.
18. Low WK and Willatt DJ. “Headache associated with nasal obstruction due to deviated nasal septum”. Headache 35 (1995): 404-406.
19. Parsons DS and Batra PS. “Functional endoscopic sinus surgical outcomes for contact point headaches”. Laryngoscope 108 (1998): 696-702.
20. Cleric DM., et al. “Endoscopic sinonasal surgery in the management of primary headaches”. Rhinology 35 (1997): 98-102.
21. Ragab SM., et al. “Evaluation of the medical and surgical treatment of chronic rhinosinusitis: a prospective, randomized, controlled trial”. Laryngoscope 114 (2004): 923-930.

Citation

Citation: Rajwant Kaur and Pawan Kumar. “Comprehensive Role of Otorhinolaryngologists in the Management of Headache: A Prospective Tertiary Care Centre Based Study". Acta Scientific Otolaryngology 3.1 (2021): 03-10.

Copyright

Copyright: © 2021 Rajwant Kaur and Pawan Kumar. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.