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Impact of Co-existing Vascular Headache on Symptom Relief After Endoscopic Sinus Surgery
Shilpa Chandrashekarappa1, Sandeep Shetty1, T Shivaram Shetty1
1Department of ENT & Head and Neck Surgery, JSS Medical College and Hospital, Mysuru, India.
Insights
Vascular headache often co-exists with chronic rhinosinusitis (CRS). In a study of 100 CRS patients, 20% experienced persistent headaches post-treatment, indicating a potential co-existing vascular headache.
Area of Science:
- Otolaryngology
- Neurology
- Clinical Medicine
Background:
- Vascular headache and chronic rhinosinusitis (CRS) share symptoms like headache and facial pain.
- The link between CRS and chronic headache, particularly vascular headache, is not well-established due to limited research.
Purpose of the Study:
- To determine the incidence of vascular headache in patients diagnosed with chronic rhinosinusitis (CRS).
Main Methods:
- A descriptive study included 100 patients with CRS and headache symptoms.
- Patients received surgical or medical management for CRS.
- Headache persistence and associated factors were assessed post-treatment using Chi-square tests.
Main Results:
- Headache was reported by 100% of CRS patients, with nasal obstruction (93%) and discharge (90%) also prevalent.
- Post-treatment, 20% of patients had persistent headaches, with 37.5% having headaches for over a year.
- Pre-operative factors like sunlight sensitivity (60%) and nausea/vomiting (56.7%) were linked to persistent headaches.
Conclusions:
- A significant portion of CRS patients with headache may have co-existing vascular headache.
- Factors such as headache duration, nausea/vomiting, and sunlight sensitivity predict persistent headaches in CRS patients.
- Targeting these factors may improve headache management in CRS patients.
Abstract:
Vascular headache and chronic rhinosinusitis (CRS) are diseases that share similar symptoms and demographics, including headache, facial pain and nasal symptoms. Contribution of chronic sinusitis as a cause of chronic headache is controversial, as there are scarce studies to know incidence of vascular headache in patients with CRS. To evaluate incidence of vascular headache in patients with CRS. Using descriptive study design, group of 100 patients with symptoms of CRS with headache were included in study. Patients underwent surgical management and 3% managed medically. Patients were assessed for associated factors with headache and further evaluated for persistence of headache postoperatively. Inferential statistics was done by Chi square test using SPSS for Windows Software (Version 21.0). Leading symptoms of CRS were headache (100%), nasal obstruction (93%), and nasal discharge (90%). Pre-treatment 25% had exposure to sunlight as aggravating factor and associated nausea vomiting in 30%. Post-treatment, follow-up at 6 months, 20% reported persisting headache, with duration of headache >1 year in 37.5% (p = 0.01). Those with pre-operative sunlight exposure as aggravating factor, headache persisted in 60% (p < 0.0001) and those with nausea/vomiting pre-treatment; headache persisted in 56.7% (p < 0.0001). These results were statistically significant. In CRS patients who had other factors contributing to headache like duration of headache more than 1 year, associated nausea/vomiting, and aggravating factors like exposure to sunlight, headache persisted after medical and surgical treatment of CRS. It signifies that 20% CRS patients with headache were having co existing vascular headache.
