ABSTRACT
Rhinogenic headache may be defined as a headache directly caused by pathology within the nose or paranasal sinuses. Rhinogenic headache is a controversial, but distinct type of headache that has received an increased amount of attention in the literature over the past twenty years. The International Classification of Headache Disorders, 3rd edition has been released by the 'International Headache Society' in May 2013. As this version is based on a large body of research on headache, in contrast to previous editions that were mostly based on opinion of experts, it is being considered as a major step forward in the diagnosis and management of headache. The International Headache Society presented the diagnostic criteria of rhinogenic headache divided into three types: Headache Attributed to Acute Rhinosinusitis, Headache Attributed to Chronic or Recurring Rhinosinusitis, Headache Attributed to Disorder of the Nasal Mucosa, Turbinates or Septum. We herein present the salient features of the new classification, which are likely to be of interest to the rhinologist. In addition, I review the evidence that intranasal mucosal contact points cause facial pain or headache and present the important points to consider in diagnosis and treatment of mucosal contact point headache.
Subject(s)
Classification , Diagnosis , Facial Pain , Headache Disorders , Headache , Nasal Mucosa , Nose , Paranasal Sinuses , Pathology , TurbinatesABSTRACT
Rhinogenic headache is a headache or facial pain syndrome secondary to mucosal contact points or rhinogenic causes in the absence of rhinitis/sinusitis. The authors report a case of atypical rhinogenic headache in a 72-year-old woman who presented with recurrent right side headache, which was aggravated by nasal breathing. A computed tomographic scan showed no evidence of rhinosinusitis and mucosal contact points. However, during nasal endoscopy, she had multiple pain-trigger points on the septum and lateral nasal wall. Treatment involved endoscopic reduction and radiofrequency diathermy of the pain-trigger point. Postoperatively, the headache was successfully relieved, and there was no evidence of recurrence. In this article, the authors present surgical option for the treatment of atypical rhinogenic headache.
Subject(s)
Aged , Female , Humans , Diathermy , Endoscopy , Facial Neuralgia , Headache , Recurrence , RespirationABSTRACT
Objective To investigate the efficacy of endoscopic intranasal structure reconstruction surgery for rhinogenous headache. Methods 82 cases of rhinogenous headache were given endoscopic intranasal structure reconstruction. Compared VAS scores before and 6 months after treatment, counted the effective rate. Results Among the 82 patients, 69 patients(84. 1%) were cured, 8 cases (9. 8%) were of obvious effect, 5 cases (6. 1%) were invalid, and the total efficiency was 93. 9%. VAS scores of the mucosal contact headache group before treatment were greater than that of the sinus headache group (P0. 05). Conclusion Endoscopic surgical operation can remove the extrusion of the nasal cavity and paranasal sinuses and factors of nasal congestion, and then reconstruct normal anatomical structure of nasal cavity, thus restoring normal function of paranasal sinuses. It has good therapeutic effect on rhinogenic headache.
ABSTRACT
La cefalea es uno de los motivos de consulta más frecuentes en medicina y se clasifica como primaria en cefaleas tensionales o migrañas y secundaria a tumores, infecciones u otras causas. Dentro del grupo de cefaleas o algias faciales secundarias se plantea la existencia del cuadro clínico de cefalea rinogénica generada por puntos de contacto de la mucosa de la cavidad nasal. En este artículo se presenta un caso de una paciente que posterior al fracaso del tratamiento farmacológico para migraña, consultó por algia facial persistente. Al realizar un examen clínico y con tomografía computarizada de las cavidades perinasales, se diagnosticó una cefalea rinogénica por contacto de mucosa secundaria a una displasia fibrosa del cornete medio. La resección quirúrgica del punto de contacto a través de una turbinectomía media realizada por cirugía endoscópica nasal abolió totalmente el dolor facial. Este caso recalca la utilidad y necesidad del estudio de las cavidades perinasales en aquellos pacientes que presentan cefalea o algia facial.
Headache is one of the most frequent symptoms in medicine that can be classified as primary, like tensional headache and migraine or secondary as in tumors, infections, or other causes. Rhinogenic headache is proposed as a clinical entity secondary to mucosal contact points within the nasal cavity. In this article we present a case of a patient that after a pharmacological treatment failure for migraine, consulted for sustained facial pain. After clinical examination and a paranasal sinus computed tomography, a rhinogenic headache secondary to middle turbinate fibrous dysplasia was diagnosed. Endoscopic surgical extirpation of contact mucosal points by a medial turbinectomy produced complete abolition of facial pain. This case illustrates the need and utility of studying paranasal sinus in those patients with headache or facial pain.