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非鼻源性头痛中的并发鼻部症状

Concurrent Nasal Symptoms in Non-Rhinogenic Headache.

作者信息

Jang David W, Wang Avivah J, Hachem Ralph Abi, Goldstein Bradley J, Witsell David L, Godley Frederick, Jiang Rong

机构信息

Department of Head and Neck Surgery and Communication Sciences Duke University Durham North Carolina USA.

University Otolaryngology Providence Rhode Island USA.

出版信息

OTO Open. 2025 Jan 27;9(1):e70083. doi: 10.1002/oto2.70083. eCollection 2025 Jan-Mar.

Abstract

OBJECTIVE

This study aims to characterize concurrent nasal symptoms in a cohort of patients with non-rhinogenic headache (NRH) presenting to an otolaryngology clinic.

STUDY DESIGN

A prospective cohort.

SETTING

Single tertiary care institution.

METHODS

Adults with NRH were recruited over a 2-year period (February 2021 to February 2023). Patients were eligible if they endorsed midfacial pain or pressure for at least 10 days a month over the previous 3 months and had no evidence of rhinosinusitis on both nasal endoscopy and computed tomography imaging. Study participants used a mobile application to keep a daily log of their facial pain/pressure, nasal congestion, and nasal mucus/discharge. Symptom severity was scored on a scale from 1 (none) to 10 (worst) for 30 consecutive days. Repeated measures correlation coefficients were calculated to evaluate overall or common intra-individual association for each symptom.

RESULTS

Twenty-eight patients were enrolled, and they completed the 30-day symptom log. Median (range) scores were 5 (1-10), 4 (1-10), and 2 (1-10) for facial pain/pressure, congestion, and mucus, respectively. Patients had significant day-to-day fluctuations in scores for all 3 symptoms, with a significant positive correlation between symptoms: congestion/mucus ( = 0.74181,  < .0001), congestion/facial pain ( = 0.5873,  = .001), and mucus/facial pain ( = 0.49384,  = .0076).

CONCLUSION

Patients with NRH often have concurrent nasal symptoms. Moreover, nasal congestion, mucus, and facial pain/pressure had significant correlations in day-to-day fluctuations in severity. Our findings suggest the possibility that all three symptoms share a common pathophysiology.

摘要

目的

本研究旨在描述就诊于耳鼻喉科门诊的非鼻源性头痛(NRH)患者队列中的并发鼻部症状。

研究设计

前瞻性队列研究。

研究地点

单一的三级医疗机构。

方法

在2年期间(2021年2月至2023年2月)招募患有NRH的成年人。如果患者在前3个月中每月有至少10天出现面中部疼痛或压痛,并且鼻内镜检查和计算机断层扫描成像均无鼻窦炎证据,则符合入选条件。研究参与者使用移动应用程序每日记录其面部疼痛/压痛、鼻塞以及鼻黏液/分泌物情况。连续30天对症状严重程度进行从1(无)到10(最严重)的评分。计算重复测量相关系数以评估每种症状的总体或个体内共同关联。

结果

招募了28名患者,他们完成了30天的症状记录。面部疼痛/压痛、鼻塞和黏液的中位数(范围)评分分别为5(1 - 10)、4(1 - 10)和2(1 - 10)。所有3种症状的评分在患者中均有显著的每日波动,症状之间存在显著正相关:鼻塞/黏液(= 0.74181,< .0001)、鼻塞/面部疼痛(= 0.5873,= .001)和黏液/面部疼痛(= 0.49384,= .0076)。

结论

NRH患者常伴有并发鼻部症状。此外,鼻塞、黏液和面部疼痛/压痛在严重程度的每日波动中具有显著相关性。我们的研究结果提示这三种症状可能共享一种共同病理生理学机制的可能性。

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