Bilal Nagihan, Selcuk Adin, Karakus Mehmet Fatih, Ikinciogullari Aykut, Ensari Serdar, Dere Huseyin
From the *ENT Clinic, Kahramanmaras Necip Fazil Sehir State Hospital, Kahramanmaras; †ENT Clinic, Kocaeli Derince Education and Research Hospital, Kocaeli; ‡ENT Clinic, Ankara Golbasi Hasvak State Hospital, Ankara; and §2th ENT Clinic, Ankara Numune Education and Research Hospital, Ankara, Turkey.
J Craniofac Surg. 2013 Sep;24(5):1688-91. doi: 10.1097/SCS.0b013e31827c7d8f.
In this study, the localization of the headache, mucosal contact points, sinonasal anatomic variations and the incidence of mucosal abnormalities were determined in patients with rhinogenic headache, and the efficacy of the corrective surgery on the severity of the headache and the rate of improvement on that localization were investigated.
Conducted in a prospective manner.
Level 2b.
Sixty-five patients who were admitted with sinonasal symptoms and headache and had septoplasty, endoscopic sinus surgery, or surgical procedures involving the nasal turbinates were included in this study. The quality and the severity of the headache were investigated preoperatively as well as in the 3rd and 12th postoperative months.
Headache was most frequently localized the frontal region. The mucosal contact points were most frequently localized between the nasal septum and the middle or inferior turbinates. Differences between preoperative headache and headache in postoperative 3rd month and postoperative 12th month were statistically significant (P < 0.05). Improvement in headache after surgery was statistically significant in cases with Haller cell and paradoxical middle turbinate and in patients with contact points between the nasal septum and the middle or inferior turbinates (P < 0.05).
We have shown the importance of surgery in the treatment of rhinogenic headache. We have also shown the reliability of the decongestion test for determining the indication for surgery. We suggest that the rhinologic surgery may have a great contribution to the treatment of headache.
本研究确定了鼻源性头痛患者头痛的定位、黏膜接触点、鼻窦解剖变异及黏膜异常的发生率，并探讨了矫正手术对头痛严重程度的疗效以及该定位改善率。
前瞻性研究。
2b级。
本研究纳入了65例因鼻窦症状和头痛入院并接受鼻中隔成形术、鼻内镜鼻窦手术或涉及鼻甲的手术的患者。术前以及术后第3个月和第12个月调查头痛的质量和严重程度。
头痛最常定位于额部区域。黏膜接触点最常定位于鼻中隔与中鼻甲或下鼻甲之间。术前头痛与术后第3个月和第12个月头痛之间的差异具有统计学意义（P<0.05）。在有Haller气房和反常中鼻甲的病例以及鼻中隔与中鼻甲或下鼻甲之间有接触点的患者中，手术后头痛的改善具有统计学意义（P<0.05）。
我们已经证明了手术在治疗鼻源性头痛中的重要性。我们还证明了减充血试验在确定手术指征方面的可靠性。我们建议鼻科手术可能对头痛治疗有很大贡献。
