Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2020, Vol. 34 ›› Issue (4): 130-133.doi: 10.6040/j.issn.1673-3770.0.2019.557

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Dynamic analysis of rhinogenic headacheZHOU Fangming1, XIE Yan2, LIU Yang2 Overview JIANG Luyun2〓Guidance 1. Chengdu University of Traditional Chinese Medicine, Chengdu 610075, Sichuan, China 2. Department of Otorhinolaryngology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610075, Sichuan, ChinaAbstract:

Rhinogenic headache is caused by rhinosinusitis or abnormal nasal anatomy. Currently, there are clear classifications and pain grading standards to diagnose the same. Further, its mechanism of action is now understood to involve trigeminal nerve stimulation and sensory neuropeptide substance P. Functional endoscopic surgery(FESS)is prioritized as a treatment modality. During surgery, it is imperative to restore the normal anatomy of the nasal cavity. Several clinical studies have reported that FESS was significantly effective in treating rhinogenic headache, with an overall effective rate of 90% and cure rate of 78%. Additionally, one report indicates that postoperative endoscopic examination and dressing change can effectively reduce the occurrence of complications and ensure safety of the treatment.   

  1. Key words: Rhinogenic headache;
    Diagnosis;
    Mechanism;
    Treatment;
    Prognosis疼痛是机体对伤害性刺激产生的最基础和灵敏的生理反应, 头痛作为最常见的疼痛类型, 既是独立的病种也是其他疾病的兼症。近年来流行病学调查显示, 我国头痛发病率可高达50%, 且发病趋势越加年轻化［1］。鼻源性头痛也是“头痛”重要的疾病分支, 过往长期作为鼻-鼻窦炎的兼症存在, 并未引起耳鼻喉科从业者的重视。随着内窥镜与影像技术的发展, 研究者们发现鼻源性头痛是独立于鼻-鼻窦炎之外的实体性疾病, 并且与鼻腔的解剖变异相关, 通过鼻内镜手术重建鼻内结构可以实现良好的治疗效果［2］。该概念一经提出, 立即引起了业界的广泛关注, 成为鼻科疾病的研究热点。时至今日, 关于该病的具体分类、作用机制、诊断标准、治疗方法等均有相关文献报道, 但结果缺乏系统性、完整性。因此我们将从鼻源性头痛的发展历史、机制、诊断、鉴别、治疗等方面对近20年相关文献进行汇总、梳理, 报道如下。
  • Received:2019-11-04 Online:2020-07-20 Published:2020-08-28

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Abstract: Rhinogenic headache is caused by rhinosinusitis or abnormal nasal anatomy. Currently, there are clear classifications and pain grading standards to diagnose the same. Further, its mechanism of action is now understood to involve trigeminal nerve stimulation and sensory neuropeptide substance P. Functional endoscopic surgery(FESS)is prioritized as a treatment modality. During surgery, it is imperative to restore the normal anatomy of the nasal cavity. Several clinical studies have reported that FESS was significantly effective in treating rhinogenic headache, with an overall effective rate of 90% and cure rate of 78%. Additionally, one report indicates that postoperative endoscopic examination and dressing change can effectively reduce the occurrence of complications and ensure safety of the treatment.

Key words: Rhinogenic headache, Diagnosis, Mechanism, Treatment, Prognosis

CLC Number: 

  • R765
[1] 刘争,张旻,刘汀哲,等. 鼻源性头痛的诊断和鉴别诊断[J]. 临床耳鼻咽喉头颈外科杂志,2012,26(11):481-482.
[2] 孙轶青,彭本刚,王欣,等. 鼻内镜下鼻内结构重建治疗鼻源性头痛[J]. 山东大学耳鼻喉眼学报,2011,25(4):50-52.
[3] Morgenstein KM, Krieger MK. Experiences in middle turbinectomy[J]. Laryngoscope, 1980, 90(10 Pt 1):1596-1603.
[4] Parsons DS, Batra PS. Functional endoscopic sinus surgical outcomes for contact point headaches[J]. Laryngoscope, 1998, 108(5):696-702.
[5] 范静平, 王海青, 吴建, 等. 鼻源性头痛临床分析[J]. 中国耳鼻咽喉颅底外科杂志, 2003, 9(5): 283-285. doi:10.3969/j.issn.1007-1520.2003.05.010. FAN Jingping, WANG Haiqing, WU Jian, et al. Clinical analyses of the nasal headache[J]. Chinese Journal of Otorhinolaryngology-Skull Base Surgery, 2003, 9(5): 283-285. doi:10.3969/j.issn.1007-1520.2003.05.010.
[6] 赖小丽. 低龄儿童鼻源性头痛25例临床分析[J]. 广西医科大学学报, 2017, 34(12): 1803-1804. doi:10.16190/j.cnki.45-1211/r.2017.12.037.
[7] 苏金柱, 李成玲, 宋英鸾, 等. 无鼻窦炎患儿鼻源性头痛诊断的探讨[J]. 中华耳鼻咽喉科杂志, 2002, 37(5): 337. doi:10.3760/j.issn:1673-0860.2002.05.026.
[8] 方英, 郑汉光. 慢性鼻源性头痛的原因及手术治疗(附82例病例分析)[J]. 中国疼痛医学杂志, 2005, 11(2): 114-115. doi:10.3969/j.issn.1006-9852.2005.02.016.
[9] 楼正才, 付涛, 杨剑, 等. 鼻科门诊鼻解剖变异及鼻源性头痛现况分析[J]. 中国疼痛医学杂志, 2009, 15(6): 330-333. doi:10.3969/j.issn.1006-9852.2009.06.004. LOU Zhengcai, FU Tao, YANG Jian, et al. The epidemiology investigation of nasal anatomy abnormality and rhi-nogenic headache in rhinology[J]. Chinese Journal of Pain Medicine, 2009, 15(6): 330-333. doi:10.3969/j.issn.1006-9852.2009.06.004.
[10] 陈明, 张长春, 商胜利, 等. 非鼻窦炎鼻源性头痛的诊断及治疗初步探讨[J]. 中国耳鼻咽喉颅底外科杂志, 2015, 21(1): 71-72.
[11] 林家峰, 王延生, 朱春生, 等. 窦口鼻道复合体解剖变异引起头痛的诊治探讨[J]. 中国耳鼻咽喉颅底外科杂志, 2005, 11(2): 112-114. doi:10.3969/j.issn.1007-1520.2005.02.013. LIN Jiafeng, WANG Yansheng, ZHU Chunsheng, et al. Headache caused by abnormality of OMC and its diagnosis and treatment[J]. Chinese Journal of Otorhinolaryngology-Skull Base Surgery, 2005, 11(2): 112-114. doi:10.3969/j.issn.1007-1520.2005.02.013.
[12] 金晓蝉, 田岳凤, 翟春涛. P物质与疼痛性疾病机制研究的分析[J]. 世界中西医结合杂志, 2018, 13(8): 1170-1172. doi:10.13935/j.cnki.sjzx.180835. JIN Xiaochan, TIAN Yuefeng, ZHAI Chuntao. Mechanisms of the substance P and painful disease[J]. World Journal of Integrated Traditional and Western Medicine, 2018, 13(8): 1170-1172. doi:10.13935/j.cnki.sjzx.180835.
[13] 石磊, 宋亚娟, 张志昱. 85例鼻源性头痛的诊断与治疗[J]. 中国耳鼻咽喉颅底外科杂志, 2013, 19(1): 80-81. doi:10.11798/j.issn.1007-1520.201301024.
[14] 陈凯, 孙艳, 徐晓院, 等. 鼻源性头痛的解剖特征与个性化手术疗效分析[J]. 中国耳鼻咽喉颅底外科杂志, 2014, 20(1): 66-68. doi:10.11798/j.issn.1007-1520.201401017.
[15] 陈凯, 李雪芬, 林煌, 等. 鼻腔结构性头痛的临床特点与手术治疗[J]. 中国耳鼻咽喉颅底外科杂志, 2011, 17(4): 298-301.
[16] 张志敏, 李国义, 陈向军, 等. 内镜下鼻内结构重建术治疗鼻源性头痛的临床疗效观察[J]. 现代中西医结合杂志, 2015, 24(6): 623-625. doi:10.3969/j.issn.1008-8849.2015.06.019.
[17] 余俏平.鼻内镜下鼻腔多结构异常所致头痛的手术治疗[J]. 中国耳鼻咽喉颅底外科杂志,2008,14(6):456-457.
[18] Behin F, Behin B, Behin D, et al. Surgical management of contact point headaches[J]. Headache: J Head Face Pain, 2005, 45(3): 204-210. doi:10.1111/j.1526-4610.2005.05045.x.
[19] 刘建华. 鼻源性头痛原因分析及内镜下鼻腔结构的重建[J]. 中国耳鼻咽喉颅底外科杂志, 2013, 19(3): 254-256. doi:10.11798/j.issn.1007-1520.201303019.
[20] Hwang PH, McLaughlin RB, Lanza DC, et al. Endoscopic septoplasty: indications, technique, and results [J]. Otolaryngol Head Neck Surg,1999,120(5):678-682.
[21] 楼正才, 楼放毅, 罗利民, 等. 鼻内接触性头痛的发病机制及诊治[J]. 解放军医学杂志, 2009, 34(5): 619-621. doi:10.3321/j.issn:0577-7402.2009.05.037. LOU Zhengcai, LOU Fangyi, LUO Liming, et al. Pathogenesis and treatment of intranasal contact point headache[J]. Medical Journal of Chinese PLA, 2009, 34(5): 619-621. doi:10.3321/j.issn:0577-7402.2009.05.037.
[22] 李慧娟. 鼻内镜下鼻腔扩容术综合治疗鼻源性头痛60例[J]. 华西医学, 2017, 32(2): 217-219. doi:10.7507/1002-0179.201503117.
[23] 杨羿容, 张恒, 鄢斌成. 手术治疗鼻腔结构异常所致鼻源性头痛的临床分析[J]. 检验医学与临床, 2015, 12(12): 1790-1791. doi:10.3969/j.issn.1672-9455.2015.12.055.
[24] 张静, 薛刚, 刘亚超, 等. 鼻腔解剖异常致鼻源性头痛75例治疗体会[J]. 中国耳鼻咽喉颅底外科杂志, 2010, 16(6): 449-451.
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