A Clinical Study of Headache in Relation to Chronic Rhinosinusitis
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2018, Vol 6, Issue 10
Abstract
Headache in Otolaryngology could be of varied origin and the sinugenic type generally presents with symptoms pointing to the site of origin, however it can only be diagnosed by meticulous clinical examination with or without imaging studies. Present study is conducted for a duration of 2 years in a government medical college of West Bengal, India to study & determine the characteristics and causes of Chronic type of Rhinosinugenic headache in Bengali population and the effect of surgery in the these patients. Out of the 200 patients 98 patients had headache due to chronic rhinosinugenic causes. Among these majority had either DNS or osteomeatal complex disease. Majority of cases with rhinogenic headache belong to 11-30 years age group. Frequency of localisation of headache was maximum at forehead. Diagnostic nasal endoscopy (DNE) revealed mucosal contact points in 61% patients. Out the patients that underwent FESS following detection of contact points, 80% had total relief from headache, and 20% had significant symptomatic relief. Some of the patients with other pathologies (DNS, osteomeatal complex disease) also underwent FESS. Post-operatively 30% were completely free of pain, 36.6% had significant symptom improvement and 33.3% had no benefit from surgery. It can be inferred that an improvement in headache in 63-67% of operated patients should be expected after FESS. Medical line of treatment only benefits acute cases of sinusitis. Microdebrider should be used for FESS as it provides atraumatic dissection with minimum bleeding, which enables decreased surgical time and lesser postoperative complications.
Authors and Affiliations
Dr. Debdulal Chakraborty, Dr. Ruma Guha, Dr. Anton Dev X, Dr. Shivaam Kesarwaani
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