Cantone E, Castagna G, Ferranti I, Cimmino M, Sicignano S, Rega F, Di Rubbo V, Iengo M
Department of Neuroscience, Reproductive and Dentistry Science, ENT Unit; "Federico II" University, Naples, Italy.
Eur Rev Med Pharmacol Sci. 2015 Jul;19(13):2327-30.
Rhinogenic headache (RH) is a headache or facial pain syndrome secondary to mucosal contact points in the sino-nasal cavities, in the absence of inflammatory signs, hyperplastic mucosa, purulent discharge, sino-nasal polyps or masses. It may result from pressure on the nasal mucosa due to anatomical variations among which the pneumatization of the middle turbinate, concha bullosa, a variant of the development of ethmoidal cells, is the most commonly observed. Clinical practice suggests a close correlation between concha bullosa, mucosal contacts and rhinogenic headache, with high impact on the QoL. However diagnostic and therapeutic difficulties still remain. Aim of the present study is to evaluate the impact of medical or surgical care on the QoL of patients suffering from concha bullosa related headache from the patients' perspective.
One-hundred-two subjects with concha bullosa and headache anamnesis were randomized into two groups and given medical or surgical treatment. To assess the Quality of life (QoL) we used visual analogue scale and for the first time, the migraine disability score before and after treatment.
After treatment the severity of the headache decreased as well as the discomfort in the surgical group compared with medical group.
The improvement of symptoms and QoL suggests that the endoscopic surgical plastic may promote the rapid resolution of concha bullosa related headache improving the and reducing health care costs.
鼻源性头痛(RH)是一种头痛或面部疼痛综合征,继发于鼻窦腔黏膜接触点,不存在炎症体征、黏膜增生、脓性分泌物、鼻息肉或肿物。它可能由解剖变异导致的鼻黏膜受压引起,其中中鼻甲气化、泡状鼻甲(筛窦气房发育的一种变异)是最常见的。临床实践表明泡状鼻甲、黏膜接触与鼻源性头痛之间存在密切关联,对生活质量有很大影响。然而,诊断和治疗仍存在困难。本研究的目的是从患者角度评估药物或手术治疗对泡状鼻甲相关头痛患者生活质量的影响。
102例有泡状鼻甲和头痛病史的受试者被随机分为两组,分别接受药物或手术治疗。为评估生活质量(QoL),我们使用视觉模拟量表,并首次在治疗前后使用偏头痛残疾评分。
与药物治疗组相比,手术组治疗后头痛严重程度降低,不适症状减轻。
症状和生活质量的改善表明,内镜手术整形可能促进泡状鼻甲相关头痛的快速缓解,改善症状并降低医疗成本。