Perceptive analysis of nasal surgery outcomes for headache

Sreenivas C., Sanjeev Kumar Awasthi


Background: Headache is the most common symptom requiring visit to a medical practitioner, sinus headache is one of the sub types of headache. Sinus related headaches are curable by surgical methods with a view to restore the functions of the maxilla-ethmo-turbinal ventilation. In this background we conducted a prospective study to investigate the perceptive relief of symptom of proven rhinosinugenic headache in patients undergoing functional endoscopic sinus surgery with septoplasty.

Methods: Prospective study, done at a command hospital, Bangalore, a tertiary PG Teaching Hospital during 2010-2011. Even though 200 patients enrolled for the study, only 98 subjects could be assessed at the end of 1 year duration. A patient centric subjective perceptional questionnaire was given preoperatively and then postoperatively on definitive intervals and the patient’s subjective score was tabulated.  

Results: Rhinosinugenic headache is common amongst 36.73% of the population in the age group of 20 to 30 years age group, followed by 25.5% in the 41 to 50 years age group. Gender distribution- 56% of females in the age group of 31 to 50 years are suffering from headache, and 28% of women in the age group of 31 to 40 years. The most common endoscopic findings were bulla ethmoidalis with a prevalence of 37.75%, followed by middle turbinate anomalies of 31.63%.

Conclusions: Endoscopy could not pick up any finding in 8.16% of the study group which was picked up by the non-contrast computerized tomography, perceptive analysis– there was an overall improvement of patient centric headache symptom alleviation of 98% after FESS with septoplasty.


sinugenic headache, Diagnostic nasal endoscopy, ethmoturbinal, functional endoscopic sinus surgery, septoplasty

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Manzoni GC, Stovner LJ. Epidemiology of Headache. Handbook Clin Neurol. 2010;97:3-22.

Silberstein SD, Wilcox TX. Nasal disease and sinus headache. 7th edition. New York Press: 2001: 494-508.

Kennedy DW. Functional endoscopic sinus surgery: technique. Arch Otolaryngol. 1985;111:643-9.

Stammberger H. Functional endoscopic sinus surgery: the Messerklinger Technique. Toronto: BC Decker; 1988.

Stammberger H, Posawetz W. Functional endoscopic sinus surgery: Indications, compli-cations and results of the Messerklinger technique. Eur Arch Otorhinolaryngol. 1990;247(2):63-76.

The Headache Classification Committee of the International Headache Society: classification and diagnostic criteria for headache disorder, cranial neuralgia and facial pains. Cephalgia. 1988;8:1-96.

Low WK, Willatt DJ. Headaches associated with nasal obstruction due to deviated nasal septum. Headache. 1995;35:404-6.

Messerklinger W. Endoskopie des unteren Nosenganges Monalsschr ohrenheilkd. Laryngo Rhinol. 1972;106:569-72.

Stammberger H. Endoscopic endonasal surgery - new concepts in treatment of recurrent sinusitis. I: anatomical and pathophysiological considerations. Otolaryngol Head Neck Surg. 1986;94:143-7.

Jareonchassi P, Thitadilok V, Bunnag C et al. Nasal endoscopic findings in patients with sinus headache. Asian Pac J Sinus Headache. 1999;17(4):261-7.

Clerico DM. Sinus headaches reconsidered: referred cephalgia of rhinological origin masquerading refractory primary headache. Headache. 1995;35:185-92.

Tosun F, Gerek M, Ozkaptan Y. Nasal surgery for contact headaches. Headache. 2004;40:237-40.