Huang Hsueh-Hsin, Lee Ta-Jen, Huang Chi-Che, Chang Po-Hung, Huang Shiang-Fu
Department of Otolaryngology, Chang Gung Memorial Hospital, Chang Gung University, Taipei, Taiwan.
Am J Otolaryngol. 2008 Sep-Oct;29(5):326-32. doi: 10.1016/j.amjoto.2007.10.001. Epub 2008 Jun 13.
This study aimed to investigate the role of anatomical abnormalities in non-sinusitis-related rhinogenous headache and to evaluate response to surgery.
Between January 1995 and December 2004, 71 patients were diagnosed with non-sinusitis-related rhinogenous headache preoperatively and treated with endoscopic sinus surgery and/or septoplasty if other underlying diseases could be ruled out and if long-term medical treatment failed. Data from this group were analyzed retrospectively.
Multiple sinonasal anomalies were noted by endoscopy and sinus computed tomographic scans in the 66 patients in the study. These included nasal septum deviation in 46 (69.7%), concha bullosum in 33 (48.5%), and Haller cell in 11 (16.7%). Thirty of the patients with nasal septum deviation needed surgical intervention. Fifty-four (81.8%) of the 66 patients in the study showed significant improvement after surgery and did not require further medical therapy.
Our experience demonstrates that non-sinusitis-related rhinogenous headache can be significantly minimized with surgical management, as long as a precise identification of the etiologic anatomical factor can be made.
本研究旨在探讨解剖学异常在非鼻窦炎相关性鼻源性头痛中的作用，并评估手术疗效。
1995年1月至2004年12月期间，71例患者术前被诊断为非鼻窦炎相关性鼻源性头痛，若能排除其他基础疾病且长期药物治疗无效，则接受鼻内镜鼻窦手术和/或鼻中隔成形术治疗。对该组患者的数据进行回顾性分析。
研究中的66例患者经鼻内镜检查和鼻窦计算机断层扫描发现存在多种鼻窦异常。其中鼻中隔偏曲46例（69.7%），泡状鼻甲33例（48.5%），Haller气房11例（16.7%）。46例鼻中隔偏曲患者中有30例需要手术干预。研究中的66例患者中有54例（81.8%）术后症状明显改善，无需进一步药物治疗。
我们的经验表明，只要能准确识别病因性解剖因素，手术治疗可显著减轻非鼻窦炎相关性鼻源性头痛。
