Sino-nasal anatomical variations in rhinogenic headache pathogenesis

Giacomo Sollini, Francesco Mazzola, Andrea Iandelli, Andrea Carobbio, Andrea Barbieri, Renzo Mora, Giorgio Peretti

Research output: Contribution to journalArticle

Abstract

Rhinogenic headache (RH) is a widespread pain syndrome but its pathogenesis and treatment are still unclear. Some authors recognize a correlation between RH and mucosal contact points or some other sinonasal anatomical variations. The authors conducted a retrospective case – control study to analyze the correlation between radiological findings and clinical symptoms. One hundred-nineteen adults with Para-Nasal Sinuses Computed Tomography (PNS-CT) scans were included: 64 patients who have originally undergone PNS-CT scan as part of rhinogenic headache workup (Group A), and 55 controls in whom PNS-CT scans were obtained for other purposes (Group B). All subjects were asked to report their symptoms using a headache scoring system. PNS-CT scans of all subjects were analyzed for presence of mucosal contact points, middle turbinate concha bullosa (MTCB) and frontoethmoidal cells. The most common anatomical abnormality found in our series was MTCB, reported in 60.9% of patients in Group A and 41.8% of those in Group B. A statistically significant prevalence was found in Group A compared to Group B regarding the presence of MTCB (P ¼ 0.037) and Type II (P ¼ 0.016) and Type III (P ¼ 0.039) frontoethmoidal cells. No statistically significant difference (P >0.05) was found between Group A and Group B regarding the presence of mucosal contact points at each site. Multiple anatomical variations in nasal and paranasal sinuses may cause a rhinogenic headache with different characteristics. Some of these, such as concha bullosa of middle turbinate or type II and III Kuhn cells, have shown a significant association with rhinogenic headache. No statistically significant association was found between presence of headache and mucosal contact points and type I and IV frontal cells. These findings can be very helpful for the surgeons that want to deal with the treatment of RH.

Original languageEnglish
Pages (from-to)1503-1505
Number of pages3
JournalJournal of Craniofacial Surgery
Volume30
Issue number5
DOIs
Publication statusPublished - Jan 1 2019

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Nose
Headache
Paranasal Sinuses
Turbinates
Tomography
Case-Control Studies
Pain
Therapeutics

Keywords

  • Concha bullosa
  • Frontoethmoidal cell
  • Mucosal contact point
  • Rhinogenic headache

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

Cite this

Sollini, G., Mazzola, F., Iandelli, A., Carobbio, A., Barbieri, A., Mora, R., & Peretti, G. (2019). Sino-nasal anatomical variations in rhinogenic headache pathogenesis. Journal of Craniofacial Surgery, 30(5), 1503-1505. https://doi.org/10.1097/SCS.0000000000005239

Sino-nasal anatomical variations in rhinogenic headache pathogenesis. / Sollini, Giacomo; Mazzola, Francesco; Iandelli, Andrea; Carobbio, Andrea; Barbieri, Andrea; Mora, Renzo; Peretti, Giorgio.

In: Journal of Craniofacial Surgery, Vol. 30, No. 5, 01.01.2019, p. 1503-1505.

Research output: Contribution to journalArticle

Sollini, G, Mazzola, F, Iandelli, A, Carobbio, A, Barbieri, A, Mora, R & Peretti, G 2019, 'Sino-nasal anatomical variations in rhinogenic headache pathogenesis', Journal of Craniofacial Surgery, vol. 30, no. 5, pp. 1503-1505. https://doi.org/10.1097/SCS.0000000000005239
Sollini G, Mazzola F, Iandelli A, Carobbio A, Barbieri A, Mora R et al. Sino-nasal anatomical variations in rhinogenic headache pathogenesis. Journal of Craniofacial Surgery. 2019 Jan 1;30(5):1503-1505. https://doi.org/10.1097/SCS.0000000000005239
Sollini, Giacomo ; Mazzola, Francesco ; Iandelli, Andrea ; Carobbio, Andrea ; Barbieri, Andrea ; Mora, Renzo ; Peretti, Giorgio. / Sino-nasal anatomical variations in rhinogenic headache pathogenesis. In: Journal of Craniofacial Surgery. 2019 ; Vol. 30, No. 5. pp. 1503-1505.
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abstract = "Rhinogenic headache (RH) is a widespread pain syndrome but its pathogenesis and treatment are still unclear. Some authors recognize a correlation between RH and mucosal contact points or some other sinonasal anatomical variations. The authors conducted a retrospective case – control study to analyze the correlation between radiological findings and clinical symptoms. One hundred-nineteen adults with Para-Nasal Sinuses Computed Tomography (PNS-CT) scans were included: 64 patients who have originally undergone PNS-CT scan as part of rhinogenic headache workup (Group A), and 55 controls in whom PNS-CT scans were obtained for other purposes (Group B). All subjects were asked to report their symptoms using a headache scoring system. PNS-CT scans of all subjects were analyzed for presence of mucosal contact points, middle turbinate concha bullosa (MTCB) and frontoethmoidal cells. The most common anatomical abnormality found in our series was MTCB, reported in 60.9{\%} of patients in Group A and 41.8{\%} of those in Group B. A statistically significant prevalence was found in Group A compared to Group B regarding the presence of MTCB (P ¼ 0.037) and Type II (P ¼ 0.016) and Type III (P ¼ 0.039) frontoethmoidal cells. No statistically significant difference (P >0.05) was found between Group A and Group B regarding the presence of mucosal contact points at each site. Multiple anatomical variations in nasal and paranasal sinuses may cause a rhinogenic headache with different characteristics. Some of these, such as concha bullosa of middle turbinate or type II and III Kuhn cells, have shown a significant association with rhinogenic headache. No statistically significant association was found between presence of headache and mucosal contact points and type I and IV frontal cells. These findings can be very helpful for the surgeons that want to deal with the treatment of RH.",
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