Ghazipour Ali, Abshirini Hassan, Hekmat Shoar Mahmood, Pursalehan Sara
Department of otorhinolaryngology, Ahwaz Jundishapur University of Medical Sciences, Ahwaz, Iran.
Iran J Otorhinolaryngol. 2011 Fall;23(65):133-9.
Investigators believe that anatomical abnormalities in the sinonasal region can be the cause of some chronic and refractory headaches that may respond well to surgical intervention. This study presents the prevalence of headache in patients with nasal septal deviation and their response to surgical treatment over a 2-year follow-up period.
This descriptive and prospective study was conducted on 98 patients with nasal septal deviation who underwent septoplasty surgery in the Imam Hospital in Ahwaz. Preoperative information was acquired by asking the patients and by completing SNOT-20 questionnaires by patients. After the surgery, information about changes in the quality of headache in patients with dominant contact points in preoperative nasal endoscopy whose headache responded to topical anaesthesia with lidocaine 2%+naphazoline 0.5% was collected over a 2-year follow-up. Final data were analyzed by SPSS and descriptive statistics.
Ninety-eight patients were studied, comprising 58.2% men and 41.8% women. They ranged in age between 18 and 46 years (mean=24). Nasal obstruction (72.4%), snoring (58.1%), headache (46%) and epistaxis (17.3%) were the most frequent preoperative symptoms. The most common site of the headache was the frontal region (68.8%). Patients' headache was bilateral in 71.1% of cases. In 82.2% of patients, headache lasted less than four hours a day. The headache was pulsatile in 53.3%, sharp in 31.2% and compressive in 15.5% of cases. In the post-operative assessment, despite gradual decline in the referral patients for follow-up, a notable and gradual recovery in patients' headache was seen with 82.8% of the patients reporting complete or partial recovery of the headache at the end of the 2-year follow-up.
Headache is one of the most common symptoms in patients with nasal anatomical abnormalities such as septal deviation and usually responds well to surgical treatment. More studies with long-term follow-ups seems to be inevitable to determine the relationship between headaches and nasal anatomical abnormalities, accurate surgical results in patients' recovery and the recurrence rate of headaches.
研究人员认为，鼻窦区域的解剖异常可能是一些慢性顽固性头痛的病因，而手术干预对此类头痛可能疗效良好。本研究呈现了鼻中隔偏曲患者的头痛患病率及其在两年随访期内对手术治疗的反应。
本描述性前瞻性研究针对98例在阿瓦士伊玛目医院接受鼻中隔成形术的鼻中隔偏曲患者开展。术前信息通过询问患者以及让患者填写SNOT - 20问卷获取。术后，在两年随访期内收集术前鼻内镜检查中有主要接触点且头痛对2%利多卡因+0.5%萘甲唑啉局部麻醉有反应的患者头痛质量变化信息。最终数据采用SPSS进行分析及描述性统计。
共研究了98例患者，其中男性占58.2%，女性占41.8%。年龄范围在18至46岁之间（平均年龄 = 24岁）。术前最常见的症状依次为鼻塞（72.4%）、打鼾（58.1%）、头痛（46%）和鼻出血（17.3%）。头痛最常见的部位是额部（68.8%）。71.1%的患者头痛为双侧性。82.2%的患者头痛每天持续时间少于4小时。53.3%的病例头痛为搏动性，31.2%为尖锐性，15.5%为压迫性。在术后评估中，尽管前来随访的患者逐渐减少，但患者的头痛有明显且逐渐的恢复，82.8%的患者在两年随访结束时报告头痛完全或部分恢复。
头痛是鼻中隔偏曲等鼻腔解剖异常患者最常见的症状之一，通常对手术治疗反应良好。似乎不可避免地需要开展更多长期随访研究，以确定头痛与鼻腔解剖异常之间的关系、准确的手术效果对患者恢复的影响以及头痛的复发率。
