DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20195704

Nasal endoscopic evaluation of patients presenting with frontal headache

Lakshmi Menon Ravunniarth, G. K. Narayana

Abstract


Background: Headache is a universal symptom affecting most people at some point in their lifetime. The most common cause of headache in ENT is acute sinusitis or an acute exacerbation of chronic sinusitis. Anatomic variations like a massive concha bullosa, enlarged ethmoidal bulla, laterally rotated uncinate can interfere with mucociliary clearance. Thus, a thorough nasal endoscopic evaluation will help us to detect any anatomic abnormality which may predispose to sinogenic headache.

Methods: 100 patients with frontal headache underwent diagnostic nasal endoscopy and all anatomic variations and pathological abnormalities were noted

Results: 83% cases had a diagnosis of deviated nasal septum or rhinosinusitis, and the rest 17% had non sinonasal cause for headache

Conclusions: Anatomic abnormalities like middle turbinate anomaly, spur, enlarged bulla, hyperplastic uncinate and pathological abnormality like mucopurulent discharge, polypi can be diagnostic of sinogenic cause for frontal headache.


Keywords


Diagnostic nasal endoscopy, Frontal headache, Deviated nasal septum

Full Text:

PDF

References


Braun EB, Scarlett JA, Schwedt TJ, Swarm RA. Pain Management in the Head and Neck Patient. In: Flint PW, ed. Cummings Otolaryngology-Head and Neck surgery. 5th ed. Philadelphia; Mosbi Elsevier; 2010: 239-249.

Clerico DM, Evan K, Montgomery L, Lanza DC, Grabo D. Endoscopic sinonasal surgery in the management of primary headaches. Rhinology. 1997;35:98-102.

Mahajan SB, Kochhar LK, Gupta AK. Sinugenic headache and nasal endoscopy. Med J Armed Forces India. 2003;59(2):121-4.

Foroughipour M, Sharifian SM, Shoeibi A, Barabad NE, Bakhshaee M. Causes of headache in patients with a primary diagnosis of sinus headache. Europ Archi Oto-Rhino-Laryngol. 2011;268(11):1593.

Bolger WE, Kennedy DW. Nasal endoscopy in the outpatient clinic. Otolaryngologic Clini North Am. 1992;25(4):791-802.

Woolford TM Jones NS. The diagnosis and management of facial pain. In Gleason M, ed. Scott Brown’s Otolaryngology and Head and Neck surgery. 7th ed. Great Britain: Hodder Arnold; 2008: 1718-1729.

Fasunla JA, Nwaorgu OGB. Adult chronic rhinosinusitis: spectrum of clinical features and management in a tertiary health institution and literature review. East Cent Afr J Surg. 2011;16(1):20-6.

Clinch RC. Evaluation of acute headaches in adults. Am Fam Physician. 2001 Feb15; 63(4):685-92.

Qubilat AR, Al-Khtoum N. Chronic headache: The role of the nasal septum deformity. Middle East J Fam Med. 2007;5(6):4-7.

Kondev L, Minster A. Headache and facial pain in children and adolescents. Otolaryngol Clin N Am. 2003;36:1153-70.

Ling FT, Kountakis SE. Important clinical symptoms in patients undergoing functional endoscopic sinus surgery for chronic rhinosinusitis. Laryngoscope. 2007;117(6):1090-3.

Nayak S, Kirtane MV, Ingle MV. Functional endoscopic sinus surgery--II (A preliminary study). J Postgrad Med. 1991;37(1):31.

Hamilos DL. Chronic rhinosinusitis: epidemiology and medical management. J Allergy Clini Immunol. 2011;128(4):693-707.

Silberstein SD. Headaches due to nasal and paranasal sinus disease. Neurologic Clin. 2004;22(1):1-9.

Benniger MS. Rhinosinusitis. In: Gleason M, ed. Scott Brown’s Otolaryngology and Head and Neck surgery. 7th ed. Great Britain: Hodder Arnold; 2008: 1439-1448.

Kikuchi H, Yoshiuchi K, Yamamoto Y, Komaki G, Akabayashi A. Diurnal variation of tension-type headache intensity and exacerbation: an investigation using computerized ecological momentary assessment. Biopsychosoc Med. 2012;6(1):18

Iansek R, Heywood J, Karnaghan J, Balla JI. Cervical spondylosis and headaches. Clin Exp Neurol. 1987;23:175-8.

Prasanna LC, Mamatha H. The location of maxillary sinus ostium and its clinical application. Indian J Otolaryngol Head Neck Surg. 2010;62(4):335-7.

Pessey JJ, Reitz C, Los F. Acute rhinosinusitis in the adult: national survey of general practice management. Revue Laryngol-Otologie-Rhinologie. 2000;121(4):237-41.

Aljibori AS, Hassan AD, Alwan AM. Assessment of nasal septal deformities by anterior rhinoscopy and nasal endoscopy. Tikrit Med J. 2010;16:14-20.

Danese M, Duvoisin B, Agrifoglio A, Cherpillod J, Krayenbuhl M. Influence of naso-sinusal anatomic variants on recurrent, persistent or chronic sinusitis. X-ray computed tomographic evaluation in 112 patients. J Radiol. 1997;78(9):651-7.

Calhoun KH, Waggenspack GA, Simpson CB, Hokanson JA, Bailey BJ. CT evaluation of the paranasal sinuses in symptomatic and asymptomatic populations. Otolaryngol Head Neck Surg. 1991;104(4):480-3.

Takanishi R. The formation of the nasal septum and the etiology of septal deformity. Acta Otolaryngol. 1987;443:1-54.

Blaugrund SM. Nasal obstruction. The nasal septum and concha bullosa. Otolaryngol Clin North Am. 1989;22(2):291-306.

Peric A, Baletic N, Soturonc J. A case of an uncommon anatomic variation of the middle turbinate associated with headache. Acta Otorhinolaryngol Italica. 2010;30:156-9.

Clifton NJ, Jones NS. Prevalence of facial pain in 108 consecutive patients with paranasal mucopurulent discharge at endoscopy. J Laryngol Otol. 2007;121(4):345-8.

Jones NS. Sinogenic facial pain: Diagnosis and management. Otolaryngol Clin N Am. 2005;38:1311-25.

Liu X, Zhang G, Xu G. Anatomic variations of the ostiomeatal complex and their correlation with chronic sinusitis: CT evaluation. Zhonghua er Bi Yan Hou Ke Za Zhi. 1999;34(3):143-6.

Mygind N, Lund VJ. Nasal polyposis. In: Gleason M, ed. Scott Brown’s Otolaryngology and Head and Neck surgery. 7th ed. Great Britain: Hodder Arnold; 2008: 1549-1559.

Lloyd GA, Lund VJ, Scadding GK. CT of the paranasal sinuses and functional endoscopic surgery: a critical analysis of 100 symptomatic patients. J Laryngol Otol. 1991;105(3):181-5.

Gupta SC, Singh M, Jain A, Walia DK. A comparative study of radiological and antroscopic findings in the lesions of maxillary sinus. Indian J Otolaryngol Head Neck Surg. 2004;1(56):9-13.

Nair S. Correlation between symptoms and radiological findings in patients of chronic rhinosinusitis: a modified radiological typing system. Rhinology. 2009;47:181-6.