Role of occipito - mental view in chronic headache, is it beneficial?

ABSTRACT

Chronic Headache is one of the common visiting symptoms in outpatient department. Amongst various investigations advised by the concerned medical practioner, . X.Ray P.N.S, occipitomental view or water's view is the most common and routine investigation. It is the most commonest radiological investigation because of easy availability of radiographic equipment, low cost and even free service available in public sector Hospitals. To determine the cause of chronic headache after viewing occipitomental view [OM] for para nasal sinuses [PNS] with history of more than one month of duration and to know that this plain radiograph is beneficial for diagnosis. Observational study. Department of Radiology. Civil Hospital Karachi. This study was conducted from October 2010 - December 2010 [3 month] in the Department of Radiology, Civil Hospital Karachi. All patients with symptom of headache of more than one month duration over the age of 18 years were included with conventional radiograph. Patients of less than 18 years of age were excluded from this study. Among 50 patient, 32 [64%] were males and 18 [36%] were females. Out of 25 [50% patients who were diagnosed as sinusitis. 17 [34%] were males and 08 [16%] were females. Pansinusitis was also detected in 13 cases [26%], 07 were males [14%] and 06 were females [12%]. Maxillary sinusitis was also found as a cause of chronic headache. This may be unilateral or bilateral. 10 [20%] cases were detected as maxillary sinusitis. Amongst them 5 [10%] were male and 5 [10%]were females. 3 cases [6%] were detected as bilateral maxillary sinusitis. 2 cases [4%]. were also having mucosal thickening and edema in frontal sinuses. One of the cause of Headache is deflected nasal septum [DNS]. In this study 5 [10%] patient were diagnosed as a case of DNS. Plain film studies ofparanasal sinuses, occipitomental view is the most frequent initial / primary imaging study advised because of its comparatively low cost, frequent availability, low radiation dose and easy to perform entity.. Although, CT Scan ofparanasal sinus is preferred choice especially when Functional Endoscopic Sinus Surgery [FESS] is planned