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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The association of headache and sinusitis was studied in 207 patients who underwent surgery for chronic sinusitis that failed to respond to medical management. Sixty-nine percent of the patients had headaches and 31% did not. In 9% headache was the only symptom and the diagnosis of sinusitis was made on clinical and/or CT grounds. The pain was usually pressure in character, moderate in intensity and lasted for hours. Its location usually, but not always, pointed to the sinuses involved. Discreet sphenoid or ethmoid disease discovered on imaging may be responsible for midline pains. Sinusitis may also trigger or aggravate vascular headaches.
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PMID:Sinusitis and headache. 855 77

Although anatomic variations in the development of the nose and paranasal sinuses such as the Haller's cell do not themselves represent a disease state, in many cases they are responsible for the patient's symptoms. Particularly in the absence of extensive associated mucosal changes, these conditions may be easily overlooked unless specifically sought. Haller's cells may cause recurrent or chronic sinusitis and persistent sinugenic headache, without significant findings on physical examination including nasal endoscopy. The presence of Haller's cells on coronal CT in a patient with corresponding symptoms deserves consideration as the potential cause of the symptoms. When medical therapy is ineffective, such cases respond well to surgical therapy through the functional endoscopic approach.
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PMID:Role of Haller's cell in headache and sinus disease: a case report. 863 63

It has been pediatric dogma that most children with cystic fibrosis (CF) have pansinusitis and few are symptomatic. To reassess this premise, we compared symptoms, clinical examinations, radiographic and surgical findings, and results of treatment in 19 children with cystic fibrosis who had undergone computed tomography at St. Christopher's Hospital (Philadelphia) from 1991 to 1994. We found two distinct patterns of sinus disease: chronic sinusitis (n = 3) and polyposis (n = 12). Two of the patients with polyposis had ethmoid mucoceles and 1 child had no sinus disease at all. Children with chronic sinusitis had headache as a major complaint, while those with polyposis suffered nasal obstruction alone unless a mucocele was present. Surgery provided marked and lasting improvement in the 14 patients who were operated on.
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PMID:Patterns of sinusitis in cystic fibrosis. 869 90

Anatomical features show maxillary sinus to be most commonly involved during childhood chronic sinusitis. Fifty-one cases who failed to respond to medications and irrigation were selected to undergo the middle meatal antrostomy under endoscopy. The majority of them had maxillary sinusitis. 10 cases had middle turbinate edema and polyps. 6 had ethmoiditis. After operations, signs of headache eliminated in 20 cases, nasal obstruction in 43 cases and yellowish discharge in 37 cases. The operative results were satisfactory. It is demonstrated that endoscopic sinus surgery is an ideal therapy for the treatment of childhood chronic maxillary sinusitis at present.
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PMID:[Endoscopic sinus surgery for chronic sinusitis in children]. 876 4

This study presents 230 patients who have been selected for endoscopic endonasal sinus surgery on the basis of a standardised diagnostic procedure. Surgery was performed by one surgeon during the period 1987 to 1991 and the Messerklinger technique (MT) was used exclusively. The selection was made from patients with nasal/paranasal complaints remitted for further treatment. Diagnostic procedures comprised a thorough anamnesis including questions about additional factors such as specific allergy of the upper airways, unspecified hyperreactivity of the nasal/paranasal mucosa, asthma, smoking, exposure to air pollution, heritage and systemic diseases, in addition to a conventional ENT-examination, endoscopy of the nasal/paranasal cavities, and tomography (conventional or computed). The patients were thereafter divided into the following groups: 1) acute recurrent and/or chronic sinusitis, 2) nasal/paranasal polyposis, 3) sinogenic headache, 4) mucoceles, and 5) olfactory dysfunction. More than 90% of the patients were treated on a day care out-patient basis, under local/topical anaesthesia combined with intravenous sedation. The extent of surgery varied in the different groups. There were no serious peroperative complications and no postoperative sequelaes. The patients were closely followed postoperatively for 1-5 years (mean 3 years and 5 months) until the study was closed at the end of 1992. We conclude that endoscopic endonasal sinus surgery demands several postoperative controls. Meticulous postoperative care is one of the basic requisites for securing optimal long-term results.
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PMID:Endoscopic endonasal sinus surgery. A long-term follow-up study. 883 51

Chronic rhinosinusitis occurs to 5% of the population with upper respiratory infections. The objective of this study is to know the main symptoms in a pediatric population younger than 14 years with the diagnosis of chronic rhinosinusitis, to know age and sex distribution and evolution. We did a medical history, physical examination, nasal cytology, skin tests and sinus X rays in each of 100 patients. Results the main symptoms were: cough, halitosis, postnasal discharge, fever, headache, sore throat, facial sensitivity and periorbital edema. This findings predominated in males and the average evolution time was 1-2 years.
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PMID:[Chronic rhinosinusitis: predominant symptoms in children under 14 years of age who were seen at the Regional Center for the Prevention and Treatment of Allergic Diseases]. 905 30

We studied the clinical efficacy of roxithromycin (RXM) administered at the daily dosage of one tablet (150 mg) for 3 months in 30 patients with chronic sinusitis. The effectiveness of this drug was evaluated on a four-point scale. Subjective and objective symptoms disappeared or decreased markedly, especially postnasal drip and nature of discharge in 80 percent or more of the patients. All symptoms significantly decreased (P < 0.001; headache P < 0.05), except for the sensation of foul odor. Symptoms improved even in those cases in which Haemophilus influenzae was detected. It is suggested that RXM produce some clinically beneficial effect through an immunological and or anti-inflammatory mechanisms in addition to its antibiotic effect.
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PMID:Clinical effect of low-dose, long-term roxithromycin chemotherapy in patients with chronic sinusitis. 905 33

Until recently, cystic fibrosis was frequently fatal during childhood. However, with current medical management, many patients are living into adulthood. This has created a new population of patients with chronic sinusitis and severe medical problems. In this report, experience with 22 patients, eight of whom have undergone sinus surgery, is presented, and recommendations for management are proposed. Presenting symptoms are typical of sinusitis, but in a few patients, severe debilitating headaches predominate. Oral antibiotics are often of little use due to the numerous courses of high dose intravenous antibiotics used for resistant pulmonary infections. Topical nasal steroids and mucolytics have been of some benefit. Fourteen operative procedures were performed on eight patients. These procedures included 12 endoscopic sphenoethmoidectomies, four Caldwell-Luc procedures, two frontal sinus obliterations, and one transseptal sphenoidotomy (many of these were in combination.) Results from this experience indicate 1) Failure of endoscopic surgery to control frontal and maxillary sinus disease; 2) Delayed healing of the ethmoid cavity with persistent crusting; and 3) Significant, albeit short term, symptomatic relief following surgical intervention. Based on this limited series, we conclude that surgery should be delayed until absolutely necessary and that an aggressive approach should be adopted when surgery is performed. In our hands this included initial endoscopic sphenoethmoidectomy with open surgical techniques used for removal of trapped inspissated secretions. We recommend long term intravenous antibiotics postoperatively and frequent cleaning of the ethmoid cavity after surgery, continuing indefinitely, to optimize the benefit of surgery.
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PMID:Management of sinusitis in adult cystic fibrosis. 906 42

Sinusitis affects up to 14% of Americans. Traditionally, most patients with sinusitis are evaluated and treated by either primary care physicians or otolaryngologists. In order to gain information regarding the characteristics at presentation and the outcome of treatment of sinusitis by an allergist, the records of 200 consecutive patients seen at the Institute for Asthma and Allergy at the Washington Hospital Center for chronic sinusitis were reviewed. The most common presenting symptoms were nasal congestion, postnasal drip, purulent rhinorrhea, headache, cough, facial pressure, anosmia or hyposmia, hypogeusia, and throat clearing. Initial abnormal physical exam findings included abnormal transillumination, purulent secretions, nasal mucosal swelling, nasal polyps, and nasal crusting. Treatment included 4 weeks of oral antibiotics, nasal corticosteroids, nasal lavage, and topical decongestants. All of the presenting symptoms (23-75% of the patients) and signs (50-84% of patients) improved with medical management. Patients have been followed for 1 to 27 months, with a mean of 6 months, and 6% have required surgery, with one complication of cerebrospinal fluid leak. These findings indicate that medical management of chronic sinusitis in an allergist's office is effective.
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PMID:Sinusitis in an allergist's office: analysis of 200 consecutive cases. 919 44

Headaches secondary to sinonasal anatomic abnormalities continue to remain a difficult entity to diagnose and to manage. This retrospective study analyzed the outcome of care for 34 patients who presented with headaches as one of their primary sinonasal complaints and were subsequently found to have contact points between the nasal septum and one or more turbinates on nasal endoscopy and/or computed tomography scan. Following functional endoscopic sinus surgery to relieve the contact points, these patients were interviewed regarding preoperative and postoperative intensity and frequency of the headaches and the overall response of the chronic sinusitis and headaches to surgery, after a mean follow-up period of 13.9 months. After surgery, reduction in intensity and frequency of headaches was experienced in 91% and 85% of the patients, respectively. This investigation demonstrates that surgical management of contact point headaches can make a significant impact on the headache symptomatology in children and adults.
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PMID:Functional endoscopic sinus surgical outcomes for contact point headaches. 959 48


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