Chronic headache: the role of deformity of the nasal septum.

Koch‐Henriksen, Nils; Gammelgaard, N; Hvidegaard, T.; Stoksted, Poul

doi:10.1136/bmj.288.6415.434

Cited by 10 publications

(1 citation statement)

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“…These include DNS, ITH, atrophy of sinus membranes, and mucosal contact [7]. For instance, one study found no improvement in headaches after septoplasty [12], while other studies describe an association between chronic headache and nasal stenosis [13,14]. A study from 2008 reported that 83% of patients indicated a signifi cant improvement in headache severity after surgery to correct nasal septum abnormalities and the associated reactive mucosal hypertrophy of the inferior turbinate, suggesting a correlation between septum deviation and referred headache [15].…”

Section: The European Position Paper On Rhinosinusitis and Nasalmentioning

confidence: 99%

Sinus or nasal surgery alleviates headache symptoms: A prospective study

Bugten¹

2018

Arch Otolaryngol Rhinold

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Introduction: The primary aim of this prospective study was to evaluate headache severity before and after surgery in patients with chronic rhinosinusitis without polyps (CRSsNP), chronic rhinosinusitis with polyps (CRSwNP), deviated nasal septum (DNS), and inferior turbinate hypertrophy (ITH). Our secondary aim was to compare the improvement of headache symptoms in these different patient groups. Methods: We enrolled 154 patients with CRSsNP, 130 patients with CRSwNP, 144 patients with DNS with or without ITH, and 69 patients with only ITH. Problems with headaches were reported on a visual analogue scale (VAS) preoperatively and six months postoperatively. Results: Patients with CRSsNP reported preoperatively signifi cantly more headaches on the VAS than the other patient groups. Headaches improved signifi cantly after surgery (p<0.001) but they improved more in CRSsNP patients than in other patient groups. Postoperatively, there were no signifi cant differences in headache problems between the groups. The CRSsNP group reported 50 (standard deviation [SD] 29) on the VAS preoperatively and 25 (SD 26) postoperatively, the CRSwNP group reported 28 (SD 30) versus 18 (SD 25), the DNS group reported 31 (SD 30) versus 17 (SD 24), and the ITH group reported 31 (SD 32) versus 19 (SD 25). Subgroup analyses identifi ed gender as a factor that has an infl uence on the headache. Female patients reported a mean VAS score of 49 (SD 31) preoperatively and 28 (SD 28) postoperatively. Male patients reported a mean VAS score of 29 (SD 29) preoperatively and 15 (SD 22) postoperatively. Conclusion: In this study, we have shown that patients with CRSsNP report more headache-related problems preoperatively than patients diagnosed with CRSwNP, DNS, or ITH. All patient groups exhibit a signifi cant improvement in their headache problems and report milder symptoms postoperatively. Female patients tend to report more headaches than men.

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