Concha bullosa related headache disability.

OBJECTIVE: Rhinogenic headache (RH) is a headache or facial pain syndrome secondary to mucosal contact points in the sino-nasal cavities, in the absence of inflammatory signs, hyperplastic mucosa, purulent discharge, sino-nasal polyps or masses. It may result from pressure on the nasal mucosa due to anatomical variations among which the pneumatization of the middle turbinate, concha bullosa, a variant of the development of ethmoidal cells, is the most commonly observed. Clinical practice suggests a close correlation between concha bullosa, mucosal contacts and rhinogenic headache, with high impact on the QoL. However diagnostic and therapeutic difficulties still remain. Aim of the present study is to evaluate the impact of medical or surgical care on the QoL of patients suffering from concha bullosa related headache from the patients' perspective. PATIENTS AND METHODS: One-hundred-two subjects with concha bullosa and headache anamnesis were randomized into two groups and given medical or surgical treatment. To assess the Quality of life (QoL) we used visual analogue scale and for the first time, the migraine disability score before and after treatment. RESULTS: After treatment the severity of the headache decreased as well as the discomfort in the surgical group compared with medical group. CONCLUSIONS: The improvement of symptoms and QoL suggests that the endoscopic surgical plastic may promote the rapid resolution of concha bullosa related headache improving the and reducing health care costs.

Benign positional paroxysmal vertigo: videonystagmographic study using rotatory test.

Benign Peripheral Paroxysmal Vertigo is a disease of the posterior labyrinth caused by endolymphatic debris, provoking vertigo with some movements of the head. Diagnosis is usually made by finding the positional nystagmus with appropriate manoeuvres. Spontaneous resolution is frequent and in these cases diagnosis is only probable and suspected from anamnesis. Aim of the present investigation was to establish more evaluation parameters in the study of Benign Peripheral Paroxysmal Vertigo. A series of 97 selected patients presenting Benign Peripheral Paroxysmal Vertigo, have been submitted to sinusoidal kinetic test. Patients have been studied during the acute phase of the condition and after recovery. Vestibulo-oculomotor reflex has been sought by stimulating the horizontal and vertical canals. Kinetic stimulus consisted in sinusoidal rotation at 0.12 Hz and 0.05 Hz. Evaluation parameters comprised preponderance, gain and phase of provoked nystagmus, recorded by means of an Ulmer videonystagmograph. Using this same technique of stimulation, 20 normal volunteers were studied in order to establish normal values for reference. Values obtained in the patient population of patients have been compared, by Student t test, with values obtained in the same cured patients and with those in normal subjects. In the patients with Benign Peripheral Paroxysmal Vertigo of the lateral canal a nystagmus preponderance toward the healthy side was observed, as well as an increase in the phase lead, also in the canals not affected by the condition. In cured patients, disappearance of the preponderance and persistence of the phase abnormalities are observed. These results suggest a multicanal pathogenesis of Benign Peripheral Paroxysmal Vertigo.