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Nonrhinologic headache in a tertiary rhinology practice
Brian F Perry1, Ivan S Login, Stilianos E Kountakis
1Departments of Otolaryngology-Head and Neck Surgery, University of Virginia, Charlottesville, Virginia, USA.
Summary
Migraine headaches are common in patients with normal sinus imaging referred for sinus issues. These patients report greater quality of life disability compared to those without headaches.
Area of Science:
- Neurology
- Otolaryngology
Background:
- Headaches are frequently misdiagnosed as rhinosinusitis.
- Sinus imaging (CT) and endoscopy often fail to identify rhinosinusitis in headache patients.
Purpose of the Study:
- To determine the etiology of headaches in patients with normal sinus evaluations.
- To compare headache severity and quality of life in different patient groups.
Main Methods:
- Prospective data collection from 100 patients with headache and normal sinus CT/endoscopy.
- Comparison of Sino-Nasal Outcomes Test (SNOT-20) scores between patients with headache as chief complaint, mild headache, and no headache.
Main Results:
- Migraine was the most frequent diagnosis (58%) in patients with headache as their primary complaint.
- Patients with headache had significantly higher mean SNOT-20 scores (24) compared to those with mild (14.6) or no headache (12.4).
Conclusions:
- Migraine is a common cause of headache in patients evaluated for rhinosinusitis but with normal sinus imaging.
- Headache significantly impacts quality of life, as indicated by higher SNOT-20 scores in affected patients.