CHRONIC MAXILLARY SINUSITIS, AN UNCOMMON AETIOLOGICAL FACTOR OF HEADACHE

Abstract

Objective: To emphasize that headache due to chronic sinusitis must be differentiated from all other forms of headache clearing the misconception of relating almost every headache with sinusitis. Design: This is a descriptive study. Place and Duration of Study: The study was carried out at the department of ENT, PNS SHIFA Naval hospital Karachi from March 2002 to March 2004. Patients and Methods: This study was carried out on 100 patients who were selected from the OPD as convenient sampling. It included patients referred to otolaryngology department who were having radiological evidence of maxillary sinusitis on plain x-ray PNS and were being investigated for headache of more than one-month duration. All the patients underwent a detailed history, clinical and E.N.T. examinations. Bilateral antral washouts were performed. Patients were compared on the bases of various parameters for instance age, gender, duration, severity, type and location of headache, effects of treatment for chronic sinusitis in ameliorating headache. A follow up for a period of three months were carried out. After the study the collected data was processed, analyzed and the final results were made. Results: Majority of the cases belonged to the age group of 21 to 35 years (70%). A large majority of the patients were not sure about any aggravating conditions. 28% cases were unable to recognize any pain-relieving factor. Only 9% patients were severely affected. 23% patients were having structured problems e.g., deviated nasal septum, nasal polypi and enlarged turbinates. In 39% cases antral wash on one or both sides revealed mucoid discharge. 17% patients expressed that they were markedly improved with the treatment. 83% did not improve remarkably, revealing that chronic maxillary sinusitis was not the main cause of headache in those patients.

Conclusion: It was concluded that although sinusitis is associated with headache in majority of the cases but headache is not a major symptom in chronic maxillary sinusitis. Patients primarily presenting with headache have chronic sinusitis in a few cases only.   It is recommended that not all the patients of headache with hazy X-ray PNS should be subjected to only the treatment of chronic sinusitis to relieve headache.