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The aim of this study was to evaluate the role of targeted nasal and sinus surgery in patients presenting with the primary
complaint of headache, with or without sinus symptoms. The study conducted was a prospective non-controlled study.
The targeted audience came from a busy metropolitan otolaryngology practice. The subjects were patients presenting with
headache, with or without other rhinogenic complaints. A prospective, non-controlled study of 50 consecutive patients
presented within a 12 month period for evaluation of headache as a primary symptom, with or without other rhinogenic
complaints. Each patient underwent a full history, examination, pre-operative sinus CT (scored by the Lund Mackay system)
and Headache Impact Test Score (HIT-6) questionnaire, followed by targeted nasal and sinus surgery. Post-operative HIT-6
was also recorded at 3 and 6 months, and the results analyzed statistically Targeted nasal and sinus surgery statistically reduced
the mean HIT-6 score postoperatively, from a mean of 61.9 preoperatively to 45.5 postoperatively (p<0.05) (a HIT-6 score >60
indicates a severe impact on quality of life, while a score <49 implies a minor impact on quality of life). Patients with a lower
Lund Mackay score had a larger drop in HIT-6 than those with a higher score. This study demonstrates a role for targeted and
limited nasal and sinus surgery as a valid therapeutic option for patients with headache having the clinical and radiographic
features described herein, and who are either not candidates for, refractory to, or not willing to use medications for control of
Peter Catalano, MD is Doctor of Medicine from Mount Sinai School of Medicine in NY. He is currently Professor of Otolaryngology at the Tufts University School of
Medicine, Chief of Otolaryngology at St. Elizabeth?s Medical Center. He has published over 74 publications in reputed journals; written over 21 book chapters; been
invited to over 175 lectures; completed 80 presentations.
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