Xie Yan, Wu Shiqi, Cui Wanling, Zeng Dandi, Chen Feifei, Liang Fangqi, Lu Rongrong, Zhang Chenyu, Jiang Luyun
Department of Otorhinolaryngology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.
School of Clinical Medicine, Chengdu University of TCM, Chengdu, China.
Front Surg. 2023 Apr 26;10:1132450. doi: 10.3389/fsurg.2023.1132450. eCollection 2023.
The objectives of this study were to analyze rhinogenic headache, i.e., noninflammatory frontal sinus headache, a headache caused by bony obstruction of the frontal sinus drainage channels that receives relatively insufficient attention clinically, and to propose endoscopic frontal sinus opening surgery as a treatment based on the etiology.
Case series.
From the data of patients with noninflammatory frontal sinus headache who underwent endoscopic frontal sinus surgery in Hospital of Chengdu University of Traditional Chinese Medicine during 2016-2021, data for three cases with detailed postoperative follow-up data were extracted for case series reports.
This report provides detailed information on three patients with noninflammatory frontal sinusitis headache. Treatment options include surgery and rechecking, with the visual analogue scale (VAS) scores of preoperative and postoperative symptoms, CT, and endoscopic images. Three patients had common characteristics: the clinical manifestations were recurrent or persistent with pain and discomfort in the forehead area, but there was no nasal obstruction or runny nose; the paranasal sinus CT revealed no signs of inflammation in the sinuses but suggested bony obstruction of the drainage channel of the frontal sinus.
All three patients had recovery from headache, nasal mucosal recovery, and patent frontal sinus drainage. The recurrence rate of forehead tightness and discomfort or pain was 0.
Noninflammatory frontal sinus headache does exist. Endoscopic frontal sinus opening surgery is a feasible treatment modality that can largely or even completely eliminate the stuffy swelling and pain in the forehead. The diagnosis and surgical indications for this disease are based on a combination of anatomical abnormalities and clinical symptoms.
本研究的目的是分析鼻源性头痛，即非炎性额窦头痛，这是一种由额窦引流通道骨质阻塞引起的头痛，临床上受到的关注相对不足，并基于病因提出内镜下额窦开放手术作为一种治疗方法。
病例系列。
从成都中医药大学附属医院2016 - 2021年接受内镜下额窦手术的非炎性额窦头痛患者的数据中，提取3例有详细术后随访数据的病例进行病例系列报告。
本报告提供了3例非炎性额窦炎头痛患者的详细信息。治疗选择包括手术和复查，有术前和术后症状的视觉模拟评分（VAS）、CT及内镜图像。3例患者有共同特点：临床表现为前额部反复或持续疼痛不适，但无鼻塞或流涕；鼻窦CT显示鼻窦无炎症迹象，但提示额窦引流通道骨质阻塞。
3例患者头痛均缓解，鼻黏膜恢复，额窦引流通畅。前额部紧绷感、不适或疼痛的复发率为0。
非炎性额窦头痛确实存在。内镜下额窦开放手术是一种可行的治疗方式，可在很大程度上甚至完全消除前额部的闷胀感和疼痛。该疾病的诊断及手术指征基于解剖异常与临床症状的结合。
