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Treatment of Sinus Headache as Migraine: The Diagnostic Utility of Triptans
Author(s) -
Kari Elina,
DelGaudio John M.
Publication year - 2008
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/mlg.0b013e318182f81d
Subject(s) - medicine , triptans , migraine , headaches , anesthesia , endoscopy , prospective cohort study , demographics , sinus (botany) , surgery , botany , demography , sociology , genus , biology
Objective: To determine the response rate to triptans in alleviating “sinus headache” in patients with endoscopy‐ and computed tomography (CT)‐negative sinus examinations. Study Design: Prospective clinical trial. Methods: Patients who presented to a tertiary care center Otolaryngology Department with primary complaints of facial pain, pressure, or headache localized over the area of the sinuses, and a self‐ or physician‐diagnosis of “sinus headache” were enrolled. Patients underwent directed history, physical examination, rigid nasal endoscopy, a sinus CT scan, and completed a headache questionnaire. Those patients that had negative findings were treated empirically with triptans. Patients completed a headache diary for each headache, using a visual analogue scale to rate the headache before and after triptan use. Response was considered as significant improvement (greater than 50% reduction of pain), partial (25–50% reduction), and no response. Results: Fifty‐four patients were enrolled. Thirty‐eight (69%) completed follow‐up, 63% were women. The mean age was 41 years (23–70). Thirty‐one patients (82%) had significant reduction of headache pain with triptan use. Thirty‐five patients (92%) had a significant reduction in headache pain in response to migraine‐directed therapy. Seventeen patients (31%) withdrew or failed to follow‐up, often reluctant to accept a diagnosis of migraine. Conclusions: This study demonstrated that the demographics of patients with self‐described “sinus headaches” who did not have findings of sinusitis on endoscopy and CT scan closely reflected the demographics of patients afflicted with migraines. It also showed that 82% of these patients had a significant response to empiric treatment for sinus headaches with triptans. These findings support that “sinus headaches” may represent migraines, and response to triptans may aid in diagnosis.