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

Indications and results of 125 Vidian neurectomies done in 64 patients have been presented. The indications were grouped as: Rhinorrhoea (37.5%), Nasal Polyposis (3.12%); Headaches and Faceaches (45.32%); and Bronchial Asthma (14-06%). Four initial Vidian neurectomies were done unilaterally and produced only partial relief in symptoms. Bilateral Vidian neurectomy relieved completely all the rhinorrhoea cases, all the nasal polyposis cases, 79-3% of headache and faceache cases and 55-5% of bronchial asthma cases.
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PMID:Bilateral Vidian neurectomy--indications and results. 85 Jan 3

Turcot's syndrome is a rare, genetically transmittable disease in which patients with colonic polyposis (possibly complicated by the progression to adenocarcinoma) have malignant central nervous system neoplasms. Dominant, recessive, and sporadic cases have been described. A 26-year-old man is reported with no relevant family history who had intermittent abdominal discomfort in 1986. Sigmoidoscopy revealed numerous polyps, several of which showed carcinomatous change. Dukes' Stage C colorectal carcinoma was diagnosed. Treatment consisted of total colectomy with construction of a Koch's pouch. He remained well for 3 years until onset of headache, nausea, and vomiting. Computed tomographic scan disclosed a large, circumscribed, enhancing, right frontoparietal mass. After craniotomy and partial resection, histologic review disclosed anaplastic astrocytoma. He received cranial radiation therapy, 6000 cGy, by parallel opposed ports to the tumor bed, and carmustine 200 mg/m2 intravenously every 8 weeks. Flow cytometric DNA analysis was done on the paraffin-embedded archival material from the patient's normal colon, colonic adenocarcinoma, and anaplastic astrocytoma. DNA histograms revealed diploid distributions in all three samples. The G2/M fraction of the astrocytoma was elevated at 16%, and the S-phase fraction of the colonic adenocarcinoma was 19.4%.
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PMID:Turcot's syndrome. Flow cytometric analysis. 165

Recurrent polyposis after 116 endonasal ethmoidectomies performed in 61 patients were investigated on the basis of functional, endoscopic and tomodensitometric data. The results of the endoscopic examinations revealed that the anterior ethmoid was involved most often (41%) with either a single localization or in combination with other sites in the sinuses. Functional rhinosinus symptomatology was satisfactory in most cases after a mean follow-up of 22 months, especially for nasal obstruction which was initially predominant (91%). Headaches, especially fronto-orbial localizations, clearly decreased after the operation but there was no correlation between the presence of headache after the operation and the recurrence of the polyposis. Computed tomography gave results similar to those obtained by endoscopy. However, a distinction could not be made between radio-opaque images of polyposis and certain cicatricial or inflammatory reactions. Unlike the functional outcome, ethmoidectomy had little effect on these images. Recurrent polyps appeared most often on the anterior ethmoid and the role of the initial infundibulotomy can be debated. It would appear that the prognosis of polyposis is not modified by extended anterior ethmoidectomy, suggesting that a more conservative surgical approach may be appropriate for frontal ethomoidal polyps.
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PMID:[Recurrence of nasosinusal polyposis after ethmoidectomy by endonasal approach. Functional, endoscopic, x-ray tomographic aspects and surgical implications]. 784 Apr 83

To demonstrate the typical clinical and CT features of sinonasal polyposis, we reviewed the clinical records and preoperative direct coronal CT scans of 35 patients with surgically proven disease. Symptoms included progressive nasal stuffiness (100%), rhinorrhea (69%), facial pain (60%), headache (43%) and anosmia (17%). We found associations with rhinitis (46%), asthma (29%) and aspirin sensitivity (9%). Coronal CT features included polypoid masses in the nasal cavity (91%), partial or complete pansinus opacification (90%), enlargement of infundibula (89%), bony attenuation of the ethmoid trabeculae (63%) and nasal septum (37%), opacified ethmoid sinuses with convex lateral walls (51%) and air-fluid levels (43%). The latter feature correlated with symptoms and signs of acute sinusitis in only 40% of patients. Recognition of sinonasal polyposis is important to the endoscopic surgeon since it can be the most troubling sinonasal inflammatory disease to manage due to its aggressive nature and tendency to recur despite appropriate treatment.
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PMID:Sinonasal polyposis: investigation by direct coronal CT. 799 Oct 94

Two male patients with cystic fibrosis (CF), both 18 years old, developed frontal lobe brain abscesses. Both patients presented with histories of intermittent headache over several days and occasional vomiting. Headache was not more evident in the mornings and not associated with visual disturbance in either patient. Neither was hypertensive nor had visual disturbance. Both patients had documented pansinusitis and nasal polyposis. Both men had had few admissions for pulmonary exacerbations, and neither was significantly malnourished. The abscess in neither patient grew Pseudomonas species.
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PMID:Cerebral abscess as a complication of cystic fibrosis. 809 Jun 10

The relationship between cystic fibrosis (CF) and sinus disease has been appreciated since at least 1959. Unfortunately the standard methods used to treat sinus disease have been very unrewarding in the CF patients. We evaluated the long-term results achieved on 17 patients with CF that underwent FES surgery between July 1988 and January 1991. This group consisted of 16 pediatric and 1 adult patients with previously diagnosed CF, documented chronic sinus disease and nasal polyposis that had failed long-term maximal medical management. The patients, or their parents, were contacted and asked to rate the severity and frequency of their symptoms associated with chronic sinus disease, pre- and postoperatively. The specific symptoms evaluated were nasal obstruction, nasal discharge, postnasal drip, halitosis and cough. In addition, we attempted to measure the number of hospitalizations and the presence and frequency of headaches. We were able to show that, while there was no change in the relative health of patients as measured by the number of hospitalizations, there was a significant improvement in the quality of life. There was a marked decline in the frequency of nasal obstruction, nasal discharge and postnasal drip and a high level of patient satisfaction with the procedure. No changes were seen in the frequency or nature of the cough, halitosis or headache.
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PMID:The results of functional endoscopic sinus (FES) surgery on the symptoms of patients with cystic fibrosis. 830 Mar 11

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

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

The endonasal microscopic sinus surgery (EMSS) in polyposis nasi is a grateful and in most cases successful procedure with a relative low risk of complications. In 1988 and 1989 we operated on 302 patients with polyposis nasi following the "Heermann Concept of EMSS". In each case the total ethmoidectomy with maxillary, sphenoid and frontal sinus surgery was performed. After an average of 5.2 years we started a follow-up in 185 patients including a questionnaire and clinical examination with endoscopic control and olfactometry. We found recurrent polyposis in 17.3% and a reoperation was necessary only in 6.5%. The complaints in polyposis as nasal obstruction, frontal cephalgia and hyposmia could be improved in more than 80%. About 26.5% of our patients suffered from bronchial asthma. Every second of them (51%) saw an improvement of asthma complaints after the operation. It is remarkable, that the clinical and endoscopic findings do not correlate in all cases with the subjective judgement of the patients. We saw patients with manifest recurrent polyposis, who did not deplore any complaints and vice versa. At last 85.4% said, that they would undergo the operation again.
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PMID:[Microscopic endonasal sinus surgery (MESS) in nasal polyposis: long term results]. 905 66

We attempted to determine the efficacy of endoscopic sinus surgery in adult patients with asthma and chronic rhinosinusitis or nasal polyposis. Fifty asthmatic patients from 17 to 74 years of age with a history of either chronic rhinosinusitis or nasal polyposis were examined. Sinonasal disease was confirmed endoscopically and with computerized tomography, and all had failed aggressive medical management of their sinonasal disease before undergoing endoscopic sinus surgery performed by the same surgeon in all cases. The following were compared for 12 months: preoperative and postoperative overall asthma control, peak flow measurements, asthma medication requirements, including the use of oral steroids, and hospitalizations for asthma. Twenty patients felt that their asthma control had improved postoperatively. Twenty per cent used less steroid inhaler, and 28% less bronchodilator inhaler. Of those 23 patients measuring peak flows, seven achieved higher levels and seven noted fewer dips and swings. Significant reductions in oral steroid requirements (p < 0.001) and hospitalization for asthma (p < 0.025) were also recorded postoperatively. Irrespective of whether the patient had chronic rhinosinusitis or nasal polyposis, both groups improved postoperatively. The commonest symptoms experienced by the group as whole and by the nasal polyposis patients were hyposmia and nasal obstruction. Postnasal discharge and headache were more important in the chronic rhinosinusitis group. Mean visual analog scores improved for all symptoms; in particular for nasal obstruction and sense of smell. Aggressive management of sinonasal pathology can improve asthma status. No major differences were recorded for outcomes when comparing patients with chronic rhinosinusitis or nasal polyposis; in particular there was no evidence for a worsening of asthma after nasal polypectomy.
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PMID:The effect of endoscopic sinus surgery on asthma: management of patients with chronic rhinosinusitis, nasal polyposis, and asthma. 1048 11


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