Relation of sinonasal anatomic variants with the frequency, pain severity and time off work in patients with migraine

Abstract

Aim: Chronic migraine (CM) is a condition characterized by attacks of severe headaches leading to an increase in time off work, decrease in work productivity and in physical functioning. The aim of this study was to investigate the role of sinus anatomic variants (SAV) on the evolution of migraine from episodic to chronic form. Methods: Two hundred and seven migraineurs [110 with episodic migraine (EM) and 97 with CM] with no evidence of nasal septal deviation with a contact point on the lateral nasal wall were evaluated for endoscopic, radiologic and anatomic variant (AV) abnormalities using Lund-Kennedy endoscopy (LKES) and Lund-Mackay radiology scores (LMRS). Headache day frequency, duration, severity and lost time at work were compared with regard to the presence of any AV and concha bullosa (CB) as well. Results: There was a very significant difference between EM and CM patients with regard to overall SAV and endoscopy scores. However, no significant difference was seen between the groups with regard to radiology scores and headache pain severity. The presence of one AV increased headache day frequency, severity and days off work in all patients. CB was found to worsen headache severity and lost time at work in all patients. Conclusions: Patients with CM have more SAV and worse endoscopy scores than patients with EM. The presence of any of the AVs increases headache day frequency, pain severity and days off work in migraineurs.

Keywords

Chronic migraine / episodic migraine / sinonasal anatomic variants / headache severity / sinus endoscopy / concha bullosa / Lund-Mackay scores / Lund-Kennedy scores

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