Research Article
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Evaluation of Paranasal Sinus Volumes and Anatomic Variations in Patients With Rhinogenic Headache

Year 2022, Volume: 19 Issue: 1, 215 - 220, 28.04.2022
https://doi.org/10.35440/hutfd.1066155

Abstract

Background: Rhinogenic headache is a common finding that may occur due to features related to the nasal cavity and paranasal sinuses without any underlying rhinological disease. It is thought that paranasal sinus volumes and anatomical variations may have an effect on this symptom. The aim of this study is; to investigate the paranasal sinus volumes and remarkable anatomical variations in patients with rhinogenic headache.
Materials and methods: Paranasal sinus tomography images and hospital files of 72 patients who were referred to the otolaryngology department were evaluated retrospectively. The volumes were calculated by the sinus volume index method and the presence of septal spur, concha bullosa, onodi cell, haller cell, agger nasi cell and paradoxical middle turbinate were evaluated as anatomical variations. As the control group, the data of 40 patients who were operated with open technique rhinoplasty for esthetic purposes were taken and the results were compared statistically.
Results: The frontal sinus volume index was 4.57 cm3 in the patient group and 6.02 cm3 in the control group, and this difference was statistically significant. No significant difference was found between the two groups in other paranasal sinus volumes. The presence of septal spur was observed more frequently in the patient group, and this result was found to be statistically significant. There was no significant difference between the two groups regarding other anatomical variations.
Conclusions: The low sinus volume may have an effect on the formation of rhinogenic headache. The presence of a septal spur may create a possible mucosal contact point, leading to rhinogenic headache.

References

  • Jensen R, Stovner LJ. Epidemiology and comorbidity of headache. Lancet Neurol 2008;7(4): 354-61.
  • Olesen J. International Classification of Headache Disorders. Lancet Neurol 2018;17(5): 396-97.
  • Sollini G, Mazzola F, Iandelli A, Carabbio A, Barbieri A, Mora R, et al. Sino-nasal anatomic variations in rhinogenic headache pathogenesis. J Craniofac Surg 2019;30:1503-1505.
  • Wolf G, Saria A, Gamse R. New aspects of the autonomic innervation of human nasal mucosa . Laryngol Rhinol Otol 1987;66:149-151.
  • Senocak D, Senocak M. Sinonasal pathology and headaches. Rhinology 2004;42:8-14.
  • Kousoulis P, Hajiioannou J, Florou V, Kretzas D, Korres G. Excessive paranasal sinuses and mastoid aeration as a possible cause of chronic headache. Case Rep Otolaryngol 2013;2013:836064.
  • Barghouth G, Prior JO, Lepori D, Duvoisin B, Schnyder P, Gudinchet F. Paranasal sinuses in children: size evaluation of maxillary, sphenoid, and frontal sinuses by magnetic resonance imaging and proposal of volume index percentile curves. Eur Radiol 2002; 12:1451-1458.
  • Cady RK, Dodick DW, Levine HL, et al. Sinus headache: a neurology, otolaryngology, allergy, and primary care consensus on diagnosis and treatment . Mayo Clin Proc 2005;80:908-916.
  • Patel ZM, Kennedy DW, Setzen M, Poetker DM, DelGaudio JM. ‘ Sinus headache’: rhinogenic headache or migraine? An evidence-based guide to diagnosis and treatment. Int Forum Allergy Rhinol 2013;3:221-230.
  • Lipton RB, Diamond S, Reed Mü Diamond ML, Stewart WF. Migraine diagnosis and treatment: results from the American Migraine Study II. Headache 2001;41:638-645.
  • Harrison L, Jones NS. Intranasal contact points as a cause of facial pain or headache: systematic review. Clin Otolaryngol 2013;38:8-22.
  • Aydemir L, Doruk C, Caytemel B, Sahin B, Sahin E, Celik M, Comoglu S, Türel MNK. Paranasal sinus volumes and headache: is there a relation? Eur Arch Otorhinolaryngol 2019;276:2267-2271.
  • Herzallah IR, Hamed MA, Salem SM, Suurna MV. Mucosal contact points and paranasal sinus pneumatization: Does radiology predict headache causality? Laryngoscope 2015;125:2021-2026.
  • Kalavagunta S, Reddy KTV. Extensive maxillary sinus pneumatization. Rhinology 2003; 41: 113-117.
  • Patel AC, Hammoudeh JA, Urata MM. Pneumosinus dilatans: a rare cause of frontal sinus expansion – case report and review of literature. Journ of Oral Maxillofac Surg 2008;66:2380-2386.
  • Ferrero V, Allais G, Rolando S, Pozzo T, Allais R, Benedetto CJ. Endonasal mucosal contact points in chronic migraine. Neuol Sci 2014;35:83-87.
  • Stammberger H, Wolf G. Headaches and sinus disease: the endoscopic approach. Ann Otol Rhinol Laryngol Suppl 1988;97:3-23.
  • Huang HH, Lee TJ, Huang CC, Chang PH, Huang SF. Non-sinusitis related rhinogenous headache: a ten-year experience. Am J Otolaryngol 2008;29:326-332.
  • Mehle ME, Kremer PS. Sinus CT scan findings in ‘sinus headache’ migraineurs. Headache 2008;48:67-71.

Rinojenik Baş Ağrısı Olan Hastalarda Paranazal Sinüs Hacimlerinin ve Anatomik Varyasyonların Değerlendirilmesi

Year 2022, Volume: 19 Issue: 1, 215 - 220, 28.04.2022
https://doi.org/10.35440/hutfd.1066155

Abstract

Amaç: Rinojenik baş ağrısı; altta yatan herhangi bir rinolojik hastalık olmadan nazal kavite ve paranazal sinüslerle ilgili özellikler nedeniyle ortaya
çıkabilen, yaygın bir bulgudur. Rinojenik baş ağrısının oluşumunda paranazal sinüs hacimleri ve anatomik varyasyonların etkisi olabileceği düşünülmektedir. Çalışmamızın amacı; rinojenik baş ağrısı olan hastaların paranazal sinüs hacimlerini ve sık karşılaşılan anatomik varyasyonların sıklığını ve bu parametrelerin bu bulgunun gelişimindeki etkisini araştırmaktır.
Materyal ve metod: Rinojenik baş ağrısı nedeniyle nöroloji bölümü tarafından kulak burun boğaz bölümüne yönlendirilmiş 72 adet hastanın paranazal sinüs tomografileri ve dosyaları retrospektif olarak değerlendirlmiştir. Hacimler sinüs volüm indeks metodu ile hesaplanmış ve anatomik varyasyon olarak septal spur, konka bülloza, onodi hücresi, haller hücresi, agger nazi hücresi ve paradoksik orta konka varlığı değerlendirilmiştir. Kontrol grubu olarak estetik amaçla açık teknik rinoplasti ameliyatı yapılmış 40 adet hastanın verileri alınmıştır ve ortaya çıkan sonuçlar istatistiksel olarak kıyaslanmıştır.
Bulgular: Hasta grubunda frontal sinüs volüm indeksi 4,57 cm3, kontrol grubunda ise 6,02 cm3 olarak ölçülmüş ve bu fark istatistiksel olarak anlamlıdır. Diğer paranazal sinüs hacimlerinde her iki grup arasında anlamlı bir fark bulunamamıştır. Anatomik varyasyon olarak sadece septal spur varlığı hasta grupta daha sık olarak gözlenmiş ve bu sonuç istatistiksel olarak anlamlı olarak bulunmuştur. Diğer anatomik varyasyonlar ile ilgili her iki grup arasında anlamlı bir fark tespit edilememiştir.
Sonuç: Rinojenik baş ağrısı oluşumunda sinüs hacimlerinin azlığının bir etkisi olabilir. Septal spur varlığı olası bir mukozal kontakt noktası yaratarak rinojenik baş ağrısına yol açabilir.

References

  • Jensen R, Stovner LJ. Epidemiology and comorbidity of headache. Lancet Neurol 2008;7(4): 354-61.
  • Olesen J. International Classification of Headache Disorders. Lancet Neurol 2018;17(5): 396-97.
  • Sollini G, Mazzola F, Iandelli A, Carabbio A, Barbieri A, Mora R, et al. Sino-nasal anatomic variations in rhinogenic headache pathogenesis. J Craniofac Surg 2019;30:1503-1505.
  • Wolf G, Saria A, Gamse R. New aspects of the autonomic innervation of human nasal mucosa . Laryngol Rhinol Otol 1987;66:149-151.
  • Senocak D, Senocak M. Sinonasal pathology and headaches. Rhinology 2004;42:8-14.
  • Kousoulis P, Hajiioannou J, Florou V, Kretzas D, Korres G. Excessive paranasal sinuses and mastoid aeration as a possible cause of chronic headache. Case Rep Otolaryngol 2013;2013:836064.
  • Barghouth G, Prior JO, Lepori D, Duvoisin B, Schnyder P, Gudinchet F. Paranasal sinuses in children: size evaluation of maxillary, sphenoid, and frontal sinuses by magnetic resonance imaging and proposal of volume index percentile curves. Eur Radiol 2002; 12:1451-1458.
  • Cady RK, Dodick DW, Levine HL, et al. Sinus headache: a neurology, otolaryngology, allergy, and primary care consensus on diagnosis and treatment . Mayo Clin Proc 2005;80:908-916.
  • Patel ZM, Kennedy DW, Setzen M, Poetker DM, DelGaudio JM. ‘ Sinus headache’: rhinogenic headache or migraine? An evidence-based guide to diagnosis and treatment. Int Forum Allergy Rhinol 2013;3:221-230.
  • Lipton RB, Diamond S, Reed Mü Diamond ML, Stewart WF. Migraine diagnosis and treatment: results from the American Migraine Study II. Headache 2001;41:638-645.
  • Harrison L, Jones NS. Intranasal contact points as a cause of facial pain or headache: systematic review. Clin Otolaryngol 2013;38:8-22.
  • Aydemir L, Doruk C, Caytemel B, Sahin B, Sahin E, Celik M, Comoglu S, Türel MNK. Paranasal sinus volumes and headache: is there a relation? Eur Arch Otorhinolaryngol 2019;276:2267-2271.
  • Herzallah IR, Hamed MA, Salem SM, Suurna MV. Mucosal contact points and paranasal sinus pneumatization: Does radiology predict headache causality? Laryngoscope 2015;125:2021-2026.
  • Kalavagunta S, Reddy KTV. Extensive maxillary sinus pneumatization. Rhinology 2003; 41: 113-117.
  • Patel AC, Hammoudeh JA, Urata MM. Pneumosinus dilatans: a rare cause of frontal sinus expansion – case report and review of literature. Journ of Oral Maxillofac Surg 2008;66:2380-2386.
  • Ferrero V, Allais G, Rolando S, Pozzo T, Allais R, Benedetto CJ. Endonasal mucosal contact points in chronic migraine. Neuol Sci 2014;35:83-87.
  • Stammberger H, Wolf G. Headaches and sinus disease: the endoscopic approach. Ann Otol Rhinol Laryngol Suppl 1988;97:3-23.
  • Huang HH, Lee TJ, Huang CC, Chang PH, Huang SF. Non-sinusitis related rhinogenous headache: a ten-year experience. Am J Otolaryngol 2008;29:326-332.
  • Mehle ME, Kremer PS. Sinus CT scan findings in ‘sinus headache’ migraineurs. Headache 2008;48:67-71.
There are 19 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Research Article
Authors

Alper Dilci 0000-0002-5364-5633

Faruk Kadri Bakkal 0000-0001-6047-2964

Necat Alataş 0000-0003-0894-2134

Hakan Yılmaz 0000-0002-4710-7927

Publication Date April 28, 2022
Submission Date January 31, 2022
Acceptance Date April 19, 2022
Published in Issue Year 2022 Volume: 19 Issue: 1

Cite

Vancouver Dilci A, Bakkal FK, Alataş N, Yılmaz H. Evaluation of Paranasal Sinus Volumes and Anatomic Variations in Patients With Rhinogenic Headache. Harran Üniversitesi Tıp Fakültesi Dergisi. 2022;19(1):215-20.

Harran Üniversitesi Tıp Fakültesi Dergisi  / Journal of Harran University Medical Faculty