泡性中鼻甲相关性头痛的临床分析

Clinical analysis of concha bullosa related headache

摘要:

目的 探讨泡性中鼻甲相关性头痛的临床诊疗方法及效果。方法 回顾性分析2017年7月-2019年10月首都医科大学宣武医院耳鼻咽喉头颈外科经筛选考虑为泡性中鼻甲相关性头痛17例患者的临床资料，其中男6例，女11例；年龄34~58岁，平均47岁。术前常规行鼻内镜检查和鼻窦CT检查以明确诊断。所有患者于全麻鼻内镜下行泡性中鼻甲修正手术，术后定期清理术腔，并进行必要的药物治疗。采用视觉模拟量表（VAS）及偏头痛残疾量表（MIDAS）评估患者手术前后头痛及生活质量改善情况。结果 17例泡性中鼻甲相关性头痛患者术后定期随访12个月。术前VAS的平均值（7.47±1.23）分明显高于术后VAS的平均值（2.18±0.95）分；术前MIDAS评分平均值（17.24±2.14）分也明显高于术后的平均值（2.53±1.23）分。术后患者头痛及生活质量明显改善，术后患者未出现严重并发症及头痛复发。结论 泡性中鼻甲相关性头痛术前鼻内镜检查结合鼻窦CT检查可明确诊断，经鼻内镜下行泡性中鼻甲修正手术，是一种经济、安全、简便易行的有效治疗手段。

关键词:鼻内镜手术;泡性中鼻甲;头痛;诊疗

Abstract:

Objective To investigate the diagnosis and treatment of concha bullosa (CB) related headache.Methods A total of 17 patients with CB related headache confirmed by computed tomography (CT) scan, nasal endoscopic examine and headache anamnesis were enrolled. All subjects received endoscopic plastic surgery of CB performed by the same surgeon with proper postoperative management. Visual analogue scale (VAS) and migraine disability score (MIDAS) were adopted to assess the headache and quality of life (QOL) before and after treatment.Results All the patients had been followed up for 12 months postoperatively. The postoperative average scores of VAS for headache 2.18±0.95 and MIDAS 2.53±1.23 were significantly lower than the preoperative ones 7.47±1.23, 17.24±2.14, which indicated relief of headache and improvement of QOL. Follow-up revealed neither serious complications nor headache recurrence.Conclusions CB related headache can be diagnosed by preoperative nasal endoscopy combined with sinus CT scan. Endoscopic plastic surgery of CB is an economic, safe, simple and effective approach for the treatment of CB related headache.

Key words:Endoscopic surgery;Concha bullosa;Headache;Diagnosis and treatment