Sinonasal Anatomic Variations in Headache Etiology
Year 2024,
Volume: 16 Issue: 3, 233 - 240, 29.10.2024
Özlem Yüksel
,
Ahmet Berkan Bilir
Meltem Esen Akpınar
Abstract
Objective: Headache is a frequent clinical symptom with multiple etiologies. Our purpose is to investigate the correlation between variations in sinonasal anatomy and headaches.
Methods: We retrospectively evaluated the paranasal computed tomography (CT) scans of patients with and without headaches. 118 patients presenting with headaches were included in the study group and 63 patients without headaches were included in the control group. Eight common anatomic variations were clarified and recorded in both groups regardless of whether unilateral or bilateral. Statistical analyses were performed with NCSS (Number Cruncher Statistical System) 2007 software. The results were evaluated at a significance level of p<0.05.
Results: Among the variations we investigated in our study agger nasi cells were observed as the most commenly encountered variation. Our study highlighted a statistically significant correlation between headaches and some anatomical variations. These variations including of Haller cell, septum-lateral nasal wall contact, and agger nasi cell.
Conclusion: Headaches have complex pathophysiological mechanisms and may be associated with sinonasal anatomic variations. The recognition of these variations will contribute to the management of the headache.
Ethical Statement
Bu çalışmada Helsinki Deklarasyonu prensiplerine uyulmuş olup çalışmaya katılmış olan insanlardan bilgilendirilmiş olur formu aldığımızı beyan ederiz.
Supporting Institution
Bu çalışmada hiçbir yazarın ilaç, firma ve ticari ürün ile ilişkisinin bulunmadığını beyan ederiz.
References
- 1. Mehle ME. What do we know about rhinogenic headache? The otolaryngologist’s challenge. Otolaryngol Clin North Am. 2014;47(2):255-64.
- 2. Ceriani CE, Silberstein SD. Headache and rhinosinusitis: A review. Cephalalgia. 2021;41(4):453-63.
- 3. Vaid S, Vaid N. Normal Anatomy and Anatomic Variants of the Paranasal Sinuses on Computed Tomography. Neuroimaging Clin N Am. 2015;25(4):527-48.
- 4. Singh Gendeh H, Singh Gendeh B. Paranasal Sinuses Anatomy and Anatomical Variations [Internet]. Paranasal Sinuses Anatomy and Conditions. IntechOpen; 2022. Available from: http://dx.doi.org/10.5772/intechopen.103733
- 5. Cohen O, Adi M, Shapira-Galitz Y, Halperin D, Warman M. Anatomic variations of the paranasal sinuses in the general pediatric population. Rhinology. 2019;57(3):206-12.
- 6. Papadopoulou AM, Chrysikos D, Samolis A, Tsakotos G, Troupis T. Anatomical Variations of the Nasal Cavities and Paranasal Sinuses: A Systematic Review. Cureus. 2021;13(1):e12727.
- 7. Nikkerdar N, Karimi A, Bazmayoon F, Golshah A. Comparison of the Type and Severity of Nasal Septal Deviation between Chronic Rhinosinusitis Patients Undergoing Functional Endoscopic Sinus Surgery and Controls. Int J Dent. 2022;2022:2925279.
- 8. Kucybała I, Janik KA, Ciuk S, Storman D, Urbanik A. Nasal Septal Deviation and Concha Bullosa - Do They Have an Impact on Maxillary Sinus Volumes and Prevalence of Maxillary Sinusitis? Pol J Radiol. 2017;82:126-33.
- 9. Kwon SH, Lee EJ, Yeo CD, Kim MG, Kim JS, Noh SJ, et al. Is septal deviation associated with headache?: A nationwide 10-year follow-up cohort study. Medicine (Baltimore). 2020;99(20):e20337.
- 10. Alsowey AM, Abdulmonaem G, Elsammak A, Fouad Y. Diagnostic Performance of Multidetector Computed Tomography (MDCT) in Diagnosis of Sinus Variations. Pol J Radiol. 2017;82:713-25.
- 11. Stammberger H. & Wolf G. (1988) Headache and sinus disease: the endoscopic approach. Ann. Otol. Rhinol. Laryngol. Suppl. 134, 3–23.
- 12. Roozbahany NA, Nasri S. Nasal and paranasal sinus: 22854054.
- 13. Welge-Luessen A, Hauser R, Schmid N, Kappos L, Probst R. Endonasal surgery for contact point headaches: a 10-year longitudinal study. Laryngoscope. 2003;113(12):2151-6.
- 14. Harrison L, Jones NS. Intranasal contact points as a cause of facial pain or headache: a systematic review. Clin Otolaryngol. 2013;38(1):8-22.
- 15. Herzallah IR, Hamed MA, Salem SM, Suurna MV. Mucosal contact points and paranasal sinus pneumatization: Does radiology predict headache causality? Laryngoscope. 2015;125(9):2021-6.
- 16. Kalaiarasi R, Ramakrishnan V, Poyyamoli S. Anatomical Variations of the Middle Turbinate Concha Bullosa and its Relationship with Chronic Sinusitis: A Prospective Radiologic Study. Int Arch Otorhinolaryngol. 2018;22(3):297-302.
- 17. Stallman JS, Lobo JN, Som PM. The incidence of concha bullosa and its relationship to nasal septal deviation and paranasal sinus disease. AJNR Am J Neuroradiol. 2004;25(9):1613-8.
- 18. Cantone E, Castagna G, Ferranti I, Cimmino M, Sicignano S, Rega F, et al. Concha bullosa related headache disability. Eur Rev Med Pharmacol Sci. 2015;19(13):2327-30.
- 19. Neskey D, Eloy JA, Casiano RR. Nasal, septal, and turbinate anatomy and embryology. Otolaryngol Clin North Am. 2009;42(2):193-205
- 20. Elvan Ö, Esen K, Çelikcan HD, Tezer MS, Özgür A. Anatomic Variations of Paranasal Region in Migraine. J Craniofac Surg. 2019;30(6):e529-e532.
- 21. Yengin Y, Çelik M, Simsek BM. Prevalence of agger nasi cell in the Turkish population; an anatomical study with computed tomography. FNG & Bilim Tıp Dergisi. 2016;2(2):84-9.
- 22. Wormald PJ. The agger nasi cell: the key to understanding the anatomy of the frontal recess. Otolaryngol Head Neck Surg. 2003;129(5):497-507.
- 23. Kantarci M, Karasen RM, Alper F, Onbas O, Okur A, Karaman A. Remarkable anatomic variations in paranasal sinus region and their clinical importance. Eur J Radiol. 2004;50(3):296-302.
- 24. Angélico FV Jr, Rapoport PB. Analysis of the Agger nasi cell and frontal sinus ostium sizes using computed tomography of the paranasal sinuses. Braz J Otorhinolaryngol. 2013;79(3):285-92.
- 25. Sollini G, Mazzola F, Iandelli A, Carobbio A, Barbieri A, Mora R, Peretti G. Sino-Nasal Anatomical Variations in Rhinogenic Headache Pathogenesis. J Craniofac Surg. 2019;30(5):1503-5.
- 26. Wanamaker HH. Role of Haller's cell in headache and sinus disease: a case report. Otolaryngol Head Neck Surg. 1996;114(2):324-7.
- 27. Ozcan KM, Selcuk A, Ozcan I, Akdogan O, Dere H. Anatomical variations of nasal turbinates. J Craniofac Surg. 2008;19(6):1678-82.
- 28. Aydinlioğlu A, Kavakli A, Erdem S. Absence of frontal sinus in Turkish individuals. Yonsei Med J. 2003;44(2):215-8.
- 29. Al-Balas HI, Nuseir A, Alzoubi F, Alomari A, Bani-Ata M, Almehzaa S, Aleshawi A. Prevalence of Frontal Sinus Aplasia in Jordanian Individuals. J Craniofac Surg. 2020;31(7):2040-2.
Baş Ağrısı Etyolojisinde Sinonazal Anatomik Varyasyonlar
Year 2024,
Volume: 16 Issue: 3, 233 - 240, 29.10.2024
Özlem Yüksel
,
Ahmet Berkan Bilir
Meltem Esen Akpınar
Abstract
Amaç: Baş ağrısı çoklu etiyolojileri olan sık görülen bir klinik semptomdur. Amacımız sinonazal anatomideki varyasyonlar ile baş ağrısı arasındaki ilişkiyi araştırmaktır.
Gereç ve Yöntem : Baş ağrısı olan ve olmayan hastaların paranazal bilgisayarlı tomografi (BT) taramaları retrospektif olarak değerlendirildi. Baş ağrısı ile başvuran 118 hasta çalışma grubuna, baş ağrısı olmayan 63 hasta ise kontrol grubuna dahil edildi. Sekiz yaygın anatomik varyasyon, tek veya çift taraflı olmasına bakılmaksızın her iki grupta da var veya yok şeklinde değerlendirildi ve kaydedildi. İstatistiksel analizler NCSS (Number Cruncher Statistical System) 2007 yazılımı ile yapıldı. Sonuçlar p<0.05 anlamlılık düzeyinde değerlendirildi.
Bulgular: Çalışmamızda incelediğimiz varyasyonlar arasında agger nasi hücreleri en sık rastlanan varyasyon olarak gözlendi. Çalışmamız baş ağrısı ile bazı anatomik varyasyonlar arasında istatistiksel olarak anlamlı bir korelasyon olduğunu ortaya koymuştur. Bu varyasyonlar arasında Haller hücresi, septumun lateral burun duvarı ile teması ve agger nasi hücresi yer almaktadır.
Sonuç Baş ağrıları karmaşık patofizyolojik mekanizmalara sahiptir ve sinonazal anatomik varyasyonlarla ilişkili olabilirler. Bu varyasyonların tanınması baş ağrısının yönetimine katkıda bulunacaktır.
References
- 1. Mehle ME. What do we know about rhinogenic headache? The otolaryngologist’s challenge. Otolaryngol Clin North Am. 2014;47(2):255-64.
- 2. Ceriani CE, Silberstein SD. Headache and rhinosinusitis: A review. Cephalalgia. 2021;41(4):453-63.
- 3. Vaid S, Vaid N. Normal Anatomy and Anatomic Variants of the Paranasal Sinuses on Computed Tomography. Neuroimaging Clin N Am. 2015;25(4):527-48.
- 4. Singh Gendeh H, Singh Gendeh B. Paranasal Sinuses Anatomy and Anatomical Variations [Internet]. Paranasal Sinuses Anatomy and Conditions. IntechOpen; 2022. Available from: http://dx.doi.org/10.5772/intechopen.103733
- 5. Cohen O, Adi M, Shapira-Galitz Y, Halperin D, Warman M. Anatomic variations of the paranasal sinuses in the general pediatric population. Rhinology. 2019;57(3):206-12.
- 6. Papadopoulou AM, Chrysikos D, Samolis A, Tsakotos G, Troupis T. Anatomical Variations of the Nasal Cavities and Paranasal Sinuses: A Systematic Review. Cureus. 2021;13(1):e12727.
- 7. Nikkerdar N, Karimi A, Bazmayoon F, Golshah A. Comparison of the Type and Severity of Nasal Septal Deviation between Chronic Rhinosinusitis Patients Undergoing Functional Endoscopic Sinus Surgery and Controls. Int J Dent. 2022;2022:2925279.
- 8. Kucybała I, Janik KA, Ciuk S, Storman D, Urbanik A. Nasal Septal Deviation and Concha Bullosa - Do They Have an Impact on Maxillary Sinus Volumes and Prevalence of Maxillary Sinusitis? Pol J Radiol. 2017;82:126-33.
- 9. Kwon SH, Lee EJ, Yeo CD, Kim MG, Kim JS, Noh SJ, et al. Is septal deviation associated with headache?: A nationwide 10-year follow-up cohort study. Medicine (Baltimore). 2020;99(20):e20337.
- 10. Alsowey AM, Abdulmonaem G, Elsammak A, Fouad Y. Diagnostic Performance of Multidetector Computed Tomography (MDCT) in Diagnosis of Sinus Variations. Pol J Radiol. 2017;82:713-25.
- 11. Stammberger H. & Wolf G. (1988) Headache and sinus disease: the endoscopic approach. Ann. Otol. Rhinol. Laryngol. Suppl. 134, 3–23.
- 12. Roozbahany NA, Nasri S. Nasal and paranasal sinus: 22854054.
- 13. Welge-Luessen A, Hauser R, Schmid N, Kappos L, Probst R. Endonasal surgery for contact point headaches: a 10-year longitudinal study. Laryngoscope. 2003;113(12):2151-6.
- 14. Harrison L, Jones NS. Intranasal contact points as a cause of facial pain or headache: a systematic review. Clin Otolaryngol. 2013;38(1):8-22.
- 15. Herzallah IR, Hamed MA, Salem SM, Suurna MV. Mucosal contact points and paranasal sinus pneumatization: Does radiology predict headache causality? Laryngoscope. 2015;125(9):2021-6.
- 16. Kalaiarasi R, Ramakrishnan V, Poyyamoli S. Anatomical Variations of the Middle Turbinate Concha Bullosa and its Relationship with Chronic Sinusitis: A Prospective Radiologic Study. Int Arch Otorhinolaryngol. 2018;22(3):297-302.
- 17. Stallman JS, Lobo JN, Som PM. The incidence of concha bullosa and its relationship to nasal septal deviation and paranasal sinus disease. AJNR Am J Neuroradiol. 2004;25(9):1613-8.
- 18. Cantone E, Castagna G, Ferranti I, Cimmino M, Sicignano S, Rega F, et al. Concha bullosa related headache disability. Eur Rev Med Pharmacol Sci. 2015;19(13):2327-30.
- 19. Neskey D, Eloy JA, Casiano RR. Nasal, septal, and turbinate anatomy and embryology. Otolaryngol Clin North Am. 2009;42(2):193-205
- 20. Elvan Ö, Esen K, Çelikcan HD, Tezer MS, Özgür A. Anatomic Variations of Paranasal Region in Migraine. J Craniofac Surg. 2019;30(6):e529-e532.
- 21. Yengin Y, Çelik M, Simsek BM. Prevalence of agger nasi cell in the Turkish population; an anatomical study with computed tomography. FNG & Bilim Tıp Dergisi. 2016;2(2):84-9.
- 22. Wormald PJ. The agger nasi cell: the key to understanding the anatomy of the frontal recess. Otolaryngol Head Neck Surg. 2003;129(5):497-507.
- 23. Kantarci M, Karasen RM, Alper F, Onbas O, Okur A, Karaman A. Remarkable anatomic variations in paranasal sinus region and their clinical importance. Eur J Radiol. 2004;50(3):296-302.
- 24. Angélico FV Jr, Rapoport PB. Analysis of the Agger nasi cell and frontal sinus ostium sizes using computed tomography of the paranasal sinuses. Braz J Otorhinolaryngol. 2013;79(3):285-92.
- 25. Sollini G, Mazzola F, Iandelli A, Carobbio A, Barbieri A, Mora R, Peretti G. Sino-Nasal Anatomical Variations in Rhinogenic Headache Pathogenesis. J Craniofac Surg. 2019;30(5):1503-5.
- 26. Wanamaker HH. Role of Haller's cell in headache and sinus disease: a case report. Otolaryngol Head Neck Surg. 1996;114(2):324-7.
- 27. Ozcan KM, Selcuk A, Ozcan I, Akdogan O, Dere H. Anatomical variations of nasal turbinates. J Craniofac Surg. 2008;19(6):1678-82.
- 28. Aydinlioğlu A, Kavakli A, Erdem S. Absence of frontal sinus in Turkish individuals. Yonsei Med J. 2003;44(2):215-8.
- 29. Al-Balas HI, Nuseir A, Alzoubi F, Alomari A, Bani-Ata M, Almehzaa S, Aleshawi A. Prevalence of Frontal Sinus Aplasia in Jordanian Individuals. J Craniofac Surg. 2020;31(7):2040-2.