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

Panorex radiographs taken during the past 5 years at the University of Kentucky College of Dentistry were reviewed for evidence of mucosal cysts of the maxillary sinus. Thirteen patients with this lesion were recalled for re-evaluation of their status. Ten of the patients had symptoms that could be related to the involved sinus. These included stuffiness, fullness, postnasal drip, gushing of yellow fluid from the nose, and headache. Radiographic examination revealed that three of the cysts had increased is size, three had decreased in size, three had not changed in size, and two had disappeared; no evaluation could be made on two. On the basis of radiographic, transillumination, history, and clinical findings, the nine cysts that could be evaluated were diagnosed as being of the nonsecretory type of mucosal cyst. We recommended periodic radiographic examination for this type of lesion. Surgical intervention is necessary only if destruction of surrounding bone has occurred or recurrence of disturbing symptoms is reported.
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PMID:A clinical study of cysts arising from mucosa of the maxillary sinus. 106 Oct 37

An accurate history is essential to the diagnosis of chronic sinusitis. Patients classically present with several weeks of daily facial pain or pressure between the eyes, headache, nasal congestion, postnasal drip, ear pain or blockage, and fatigue. The headache in chronic sinusitis is usually worse in the morning and following head movement. Purulent nasal discharge, spiking fever, an elevated white blood cell count, and intense, brief headache associated with nausea and vomiting are uncommon. Palpation, transillumination of the sinuses and anterior rhinoscopy are of minimal value in making the diagnosis. Fiberoptic nasopharyngoscopy can be used to identify the source of sinus discharge and the cause of obstruction. Although plain sinus radiographs are useful in diagnosing and monitoring acute sinusitis, they are of limited value in confirming chronic sinusitis. The sinuses are better imaged with computed tomographic scanning. Prolonged antibiotic therapy, in combination with decongestants and steroids, is usually effective for chronic sinusitis. In recalcitrant cases, sinus surgery may be necessary.
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PMID:Chronic sinusitis: an update. 157 14

The efficacy of sinus surgery continues to be an issue of debate among otolaryngologists. In an attempt to address this controversy, a case-series study design was used to assess the perceived efficacy of sinus surgery in terms of the alleviation of sinus symptoms and overall health benefit. Self-administered questionnaires were mailed to 142 individuals who had sinus surgery performed between January 1984, and December 1985. After one follow-up attempt, 114 questionnaires were completed and returned (80% response). Overall, a high percentage of cases reported postoperative improvement in breathing difficulties (90%), nasal congestion (88%), headache/facial pain (85%), recurrent sinus infections (83%), and postnasal drip (80%). In addition, 88% of cases reported the surgery to be of some overall health benefit. These results suggest that sinus surgery, as perceived by surgically treated individuals, may be effective in the management of chronic sinus disease.
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PMID:Sinus disease and surgical treatment: a results oriented quality assurance study. 250 32

An open, parallel comparison of flunisolide and beclomethasone dipropionate nasal sprays is described. Sixty patients entered the study of whom fifty-six completed the full 4 weeks' therapy. The dosage of flunisolide was two actuations (25 micrograms/actuation) into each nostril twice a day (total 200 micrograms). The dosage of beclomethasone dipropionate was one actuation (50 micrograms) in each nostril four times a day (total 400 micrograms). Both drugs produced statistically significant improvements compared with admission values in sneezing, stuffiness, runny nose, nose blowing and post-nasal drip. Both drug significantly decreased the interference by symptoms with routine life and sleep. At the end of the trial both treatment groups showed total or good control of symptoms in the majority of patients. No statistically significant difference was shown between the effects of the two drugs. Side-effects did not cause withdrawal from the trial in any patient and were mostly confined to minor headache and nose and throat complaints. In neither treatment group was there any evidence of adrenal suppression or growths of Candida from nasal swabs.
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PMID:A comparative trial of flunisolide and beclomethasone dipropionate in the treatment of perennial allergic rhinitis. 698 6

We examined the prevalence of chronic sinusitis among children who presented to allergy clinics with chronic (> or = 3 months) respiratory symptoms. Ninety-one patients, ranging from 2 to 17 years of age with 62% male and 72% white, completed the study. Fifty-nine percent of patients had positive skin test results, and 25.3% had chronic asthma. Paranasal sinuses were examined by coronal sinus computed tomographic scan. Sixty-three percent (58 to 91) had chronic sinusitis, 5.5% (5 of 91) had concha bullosa, 1% (1 of 91) had foreign body, and 19% (19 of 91) had deviated nasal septums. Among symptoms of sneezing, nasal congestion, postnasal drip, coughing, wheezing, rhinorrhea, and headache, no single symptom was an acceptable predictor of abnormality on computed tomographic scan examinations. Combining the symptoms of moderate to severe rhinorrhea and cough with minimum sneezing had a specificity of 95% and a sensitivity of 38% in predicting the presence of chronic sinusitis. Allergic rhinitis (p = 0.27), mild deviated nasal septum (p = 0.11), unobstructive concha bullosa (p = 0.13), and passive exposure to cigarette smoke (p = 0.53) were not risk factors associated with sinus abnormalities. Age (r = 0.30, p = 0.004) in pediatric patients with chronic respiratory symptoms was the single risk factor significantly associated with abnormalities on sinus computed tomographic scan. Seventy-three percent of children 2 to 6 years of age, 74% of children 6 to 10 years of age, and 38% of children older than 10 had chronic sinusitis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Chronic sinusitis among pediatric patients with chronic respiratory complaints. 825 16

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

The impact of chronic sinusitis on children has become more apparent as the awareness of the disease has increased. Consequently, the knowledge of its effect in the pediatric patient has expanded dramatically. Functional endoscopic sinus surgery (FESS) has become the primary surgical modality for treatment of this illness in children who have not responded to optimal medical management. A retrospective study was conducted in patients from 7 months to 17 years of age who were treated with FESS for chronic sinusitis refractory to medical therapy. Using a comprehensive parental questionnaire and a review of the medical charts, results were analyzed from these post-FESS children. Parents of the children were interviewed with a mean follow-up time of 21.8 months postoperatively. Factors discussed included chronic nasal obstruction, purulent nasal discharge, postnasal drip, chronic cough, halitosis, headaches, behavioral problems, allergies, and asthma symptoms. This preliminary investigation suggests that FESS is effective in treating medically recalcitrant severe chronic sinusitis in children.
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PMID:Functional endoscopic surgery in children: a retrospective analysis of results. 836 Dec 92

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

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

In winter, children with mold allergy may develop persistent cold-like symptoms (PCLS) that often defy conventional therapy. To investigate the cause of PCLS, we enrolled 44 children (25 with PCLS and 19 controls) in a 2-year study to compare their clinical symptoms and the mold count in their homes. Children with PCLS had a higher percent of eosinophils in nasal smears as compared with those without PCLS (32% vs 26%). On a scale of 0 to 3, the PCLS group had higher symptom scores (P < 0.001 for all symptoms): bloodshot eyes (2.92 vs 0.79), mouth breathing (2.04 vs 0.68), rhinorrhea (2.48 vs 0.89), nasal voice (2.68 vs 1.00), postnasal drip (2.64 vs 0.47), and headache (2.72 vs 0.53) than the non-PCLS group. The clinical scores also correlated significantly with the mold count in the home (the r value ranged from 0.6716 to 0.7450). We conclude that management of children with PCLS should include decreasing humidity and enforcing environmental control to eradicate mold from inside the homes.
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PMID:Mold allergy is a risk factor for persistent cold-like symptoms in children. 941 37


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