J Rhinol.  2015 May;22(1):6-10. 10.18787/jr.2015.22.1.6.

Prospective Study on the Characteristics and Postoperative Improvement of Rhinogenic Headache

Affiliations
  • 1Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Korea. dongkim@snu.ac.kr
  • 2Department of Otorhinolaryngology-Head and Neck Surgery, Chosun University College of Medicine, Gwang-ju, Korea.
  • 3Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University College of Medicine, Pusan, Korea.
  • 4Department of Otorhinolaryngology-Head and Neck Surgery, Soon Chun Hyang University College of Medicine, Seoul, Korea.
  • 5Research Center for Sensory Organs, Seoul National University College of Medicine, Seoul, Korea.

Abstract

BACKGROUND AND OBJECTIVES
Headache secondary to sinonasal disease can improve after surgery, but few prospective studies have investigated this outcome. We aimed to evaluate the characteristics of headaches, such as clinical features, underlying disease, and postoperative improvement in patients who underwent nasal surgery, and to identify the characteristics that reliably predict rhinogenic headache. MATERIALS AND METHOD: Of 356 patients who underwent nasal surgery between March and December 2009, 41 patients with headaches were enrolled in this prospective study. Clinical features of headache, such as onset, time of day, duration, frequency, nature, side and location, existence of aura, aggravating and relieving factors and accompanying nasal symptoms, underlying diseases, endoscopic findings, and computed tomography scans of the paranasal sinuses were evaluated. Headache intensity was graded based on a 10-point visual analog scale (VAS) pre- and post-operatively.
RESULTS
The most common characteristics of rhinogenic headache included a stabbing or squeezing nature, frontal area location, accompanying nasal obstruction or rhinorrhea, and underlying sinusitis or septal deviation. The subjective intensity of the headache, measured using the VAS score, improved in 80% (33/41) of the patients after surgery.
CONCLUSION
Nasal surgery should be considered when rhinogenic headache is suspected and there are definite nasal pathologies.

Keyword

Headache; Nasal disease; Prospective study; Nasal surgery; Postoperative pain
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