Lin S-H, Ho C-Y
Department of Otolaryngology, Taipei Veterans General Hospital, Taipei, Taiwan.
Cephalalgia. 2006 Apr;26(4):423-7. doi: 10.1111/j.1468-2982.2005.01058.x.
Headache is a frequent symptom of lesions in the paranasal sinuses. Although some inflammatory symptoms are suggestive of pathologies of the paranasal sinuses, occasional headache is sometimes the major presenting symptom. In a retrospective study, we examined the chart histories of 36 patients presenting for treatment at our hospital from 1 January 1992 to 30 June 2001 who were diagnosed as having pathologies of the paranasal sinuses with the primary symptom being headache. All patients had been evaluated with complete otolaryngological and neurological examinations, diagnostic nasal endoscopy, and sinus computed tomographic (CT) scans. Sinus surgery was arranged after failure in performing appropriate medical treatment. Among the 36 patients, 33 showed significant improvement after sinus operation (92%). A paranasal sinus aetiology of headache is an important factor in the differential diagnosis of chronic headache. Those patients who are clinically suspected of having headaches arising from paranasal sinus pathology should receive comprehensive otorhinolaryngological examination and evaluation. Nasal endoscopy and sinus CT scans are good diagnostic tools. Surgical management may be beneficial in those for whom medical treatment fails to resolve the problem.
头痛是鼻窦病变的常见症状。虽然一些炎症症状提示鼻窦病变，但偶尔头痛有时是主要的就诊症状。在一项回顾性研究中，我们检查了1992年1月1日至2001年6月30日期间在我院就诊并被诊断为鼻窦病变且主要症状为头痛的36例患者的病历。所有患者均接受了全面的耳鼻喉科和神经科检查、诊断性鼻内镜检查以及鼻窦计算机断层扫描（CT）。在适当的药物治疗失败后安排鼻窦手术。36例患者中，33例（92%）鼻窦手术后有明显改善。鼻窦病因引起的头痛是慢性头痛鉴别诊断中的一个重要因素。临床上怀疑头痛由鼻窦病变引起的患者应接受全面的耳鼻喉科检查和评估。鼻内镜检查和鼻窦CT扫描是很好的诊断工具。对于药物治疗未能解决问题的患者，手术治疗可能有益。
