Sinus or nasal surgery alleviates headache symptoms: A prospective study
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Introduction: The primary aim of this prospective study was to evaluate headache severity before and after surgery in patients with chronic rhinosinusitis without polyps (CRSsNP), chronic rhinosinusitis with polyps (CRSwNP), deviated nasal septum (DNS), and inferior turbinate hypertrophy (ITH). Our secondary aim was to compare the improvement of headache symptoms in these different patient groups. Methods: We enrolled 154 patients with CRSsNP, 130 patients with CRSwNP, 144 patients with DNS with or without ITH, and 69 patients with only ITH. Problems with headaches were reported on a visual analogue scale (VAS) preoperatively and six months postoperatively. Results: Patients with CRSsNP reported preoperatively significantly more headaches on the VAS than the other patient groups. Headaches improved significantly after surgery (p<0.001) but they improved more in CRSsNP patients than in other patient groups. Postoperatively, there were no significant differences in headache problems between the groups. The CRSsNP group reported 50 (standard deviation [SD] 29) on the VAS preoperatively and 25 (SD 26) postoperatively, the CRSwNP group reported 28 (SD 30) versus 18 (SD 25), the DNS group reported 31 (SD 30) versus 17 (SD 24), and the ITH group reported 31 (SD 32) versus 19 (SD 25). Subgroup analyses identified gender as a factor that has an influence on the headache. Female patients reported a mean VAS score of 49 (SD 31) preoperatively and 28 (SD 28) postoperatively. Male patients reported a mean VAS score of 29 (SD 29) preoperatively and 15 (SD 22) postoperatively. Conclusion: In this study, we have shown that patients with CRSsNP report more headache-related problems preoperatively than patients diagnosed with CRSwNP, DNS, or ITH. All patient groups exhibit a significant improvement in their headache problems and report milder symptoms postoperatively. Female patients tend to report more headaches than men.