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Sino-Nasal Anatomical Variations in Rhinogenic Headache Pathogenesis
Giacomo Sollini1, Francesco Mazzola, Andrea Iandelli
1Department of Otorhinolaryngology-Head and Neck Surgery, University of Genoa, Genova, Italy.
The Journal of Craniofacial Surgery
|July 14, 2019
Summary
Anatomical variations in the nasal sinuses, specifically middle turbinate concha bullosa and certain frontoethmoidal cells, are significantly associated with rhinogenic headaches. These findings aid surgeons in treating this common pain syndrome.
Area of Science:
- Otolaryngology
- Radiology
- Pain Medicine
Background:
- Rhinogenic headache (RH) is a prevalent pain syndrome with unclear origins.
- Potential links between RH and sinonasal anatomical variations are recognized.
- Surgical interventions for RH require a better understanding of its underlying causes.
Purpose of the Study:
- To investigate the correlation between radiological findings and clinical symptoms in patients with rhinogenic headaches.
- To identify specific sinonasal anatomical variations associated with RH.
Main Methods:
- A retrospective case-control study involving 119 adults.
- Para-nasal sinuses computed tomography (PNS-CT) scans were analyzed for anatomical variations.
- Patients were categorized into a rhinogenic headache group (Group A) and a control group (Group B).
- Headache symptoms were assessed using a standardized scoring system.
Main Results:
- Middle turbinate concha bullosa (MTCB) was more prevalent in Group A (60.9%) than Group B (41.8%).
- A statistically significant association was found between Group A and the presence of MTCB (P=0.037), Type II (P=0.016), and Type III (P=0.039) frontoethmoidal cells.
- No significant difference in mucosal contact points or Type I/IV frontoethmoidal cells was observed between groups.
Conclusions:
- Specific sinonasal anatomical variations, including MTCB and certain frontoethmoidal cells, are significantly associated with rhinogenic headaches.
- These findings provide valuable insights for surgeons managing RH.
- Further research may elucidate the precise mechanisms linking these variations to headache.
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