Kaymakci Mustafa, Cikriklar Halil Ibrahim, Pay Gunes
Department of Otorhinolaryngology, Head and Neck Surgery, Balikesir University, Balikesir, Turkey.
J Int Med Res. 2013 Feb;41(1):218-23. doi: 10.1177/0300060513475382. Epub 2013 Jan 23.
Patients with sinus headaches usually complain of pain and pressure sensation around the sinuses and periorbital area; most are misdiagnosed with sinusitis and receive unnecessary treatment. This prospective study investigated the aetiology of sinus headache in patients with negative endoscopic or computed tomography (CT) scan findings.
This multicentre study included patients who could be followed regularly after being admitted to otorhinolaryngology outpatient or emergency units due to sinus headache, in whom endoscopic and radiological examinations did not show sinonasal pathology. The study group comprised patients with primary headache, according to International Headache Society criteria. Participants were followed monthly for 3 months and treatment response was evaluated as complete remission, partial remission or no response.
The study included 98 patients. The main reason for diagnosing and treating sinus headaches that arose from neurovascular events was attributed to the accompanying symptoms, e.g. nasal obstruction, nasal discharge and sinus sensitivity.
A better understanding of vascular event-derived headaches (especially migraine) and a detailed examination of patients via endoscopy and CT scanning are expected to minimize misdiagnosis rates, in patients with sinus headaches.
鼻窦性头痛患者通常主诉鼻窦及眶周区域疼痛和压迫感；大多数患者被误诊为鼻窦炎并接受了不必要的治疗。这项前瞻性研究调查了内镜检查或计算机断层扫描（CT）结果为阴性的鼻窦性头痛患者的病因。
这项多中心研究纳入了因鼻窦性头痛入住耳鼻喉科门诊或急诊单元后可定期随访的患者，这些患者的内镜和影像学检查未显示鼻窦病变。根据国际头痛协会标准，研究组包括原发性头痛患者。参与者每月随访3个月，并将治疗反应评估为完全缓解、部分缓解或无反应。
该研究纳入了98例患者。将神经血管事件引起的鼻窦性头痛误诊并进行治疗的主要原因是伴随症状，如鼻塞、流涕和鼻窦敏感。
更好地了解血管事件性头痛（尤其是偏头痛），并通过内镜检查和CT扫描对患者进行详细检查，有望降低鼻窦性头痛患者的误诊率。
