title: Endoscopic sinonasal surgery in the management of primary headaches.
abstract: Primary headaches (migraine, cluster, tension-type) are common disorders thought to be unrelated to nasal and sinus abnormalities. We present data on 19 patients with refractory primary headaches in the absence of significant sinus symptoms. The majority of patients responded with decreased pain to office application of nasal anaesthesia. A high prevalence of sinonasal abnormalities was found on coronal CT scans. Seventy-nine per cent responded with either decreased pain severity or headache frequency after endoscopic sinonasal surgery. We discuss possible underlying mechanisms to explain these findings.
authors.affiliation: Department of Otorhinolaryngology/Head and Neck Surgery, University of Pennsylvania Medical Center, Philadelphia, USA.
authors.forename: D M
authors.initials: DM
authors.lastname: Clerico
authors.forename: K
authors.initials: K
authors.lastname: Evan
authors.forename: L
authors.initials: L
authors.lastname: Montgomery
authors.forename: D C
authors.initials: DC
authors.lastname: Lanza
authors.forename: D
authors.initials: D
authors.lastname: Grabo
mesh_terms: D000293:Adolescent; D000328:Adult; D004724:Endoscopy; D005260:Female; D006261:Headache / Q000209:etiology / Q000378:metabolism / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009297:Nasal Mucosa / Q000378:metabolism; D010147:Pain Measurement; D010256:Paranasal Sinuses / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000601:surgery*; D013373:Substance P / Q000378:metabolism; D014057:Tomography, X-Ray Computed
chemical_list: D013373:Substance P