Skip to main content
AAO-HNSF 2024 Annual Meeting & OTO EXPO Main banner
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Back

Scientific Oral Presentations

Comprehensive Otolaryngology

Session: Scientific Oral Presentations 2 - Comprehensive Otolaryngology

Concurrent Nasal Symptoms in Non-Rhinogenic Headache: Coincidence or Not

Sunday, September 29, 2024
1:00 PM – 1:06 PM EDT
Location: MBCC, 206
Disclosure(s):
Avivah J. Wang, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Frederick A. Godley, MD, III:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Bradley J. Goldstein, MD, PhD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

David L. Witsell, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

David W. Jang, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Patients presenting with non-rhinogenic headache often report concurrent nasal symptoms, which can lead to a misdiagnosis of sinusitis and unnecessary treatment with antibiotics. The purpose of this study was to characterize concurrent nasal symptoms (nasal mucus, congestion) in a cohort of patients with non-rhinogenic headache presenting to an otolaryngology clinic.

Methods: A prospective cohort of adult patients with non-rhinogenic headache were recruited over a two-year period (Feb 2021 – Feb 2023). Patients were eligible if they endorsed midfacial pain or pressure at least 10 days a month for the previous three months and had no evidence of rhinosinusitis on both nasal endoscopy and CT imaging. Study participants used a mobile application to keep a daily log of their facial pain/pressure, nasal congestion, and nasal mucus/discharge. Symptom severity was scored on a scale from 1 (none) to 10 (worst) for thirty consecutive days. Repeated measures correlation coefficients were calculated to evaluate the overall or common intra-individual association using daily scores for each symptom.

Results: Twenty-eight patients were enrolled and completed the thirty-day symptom log. The mean age of participants was 49 (12.5) years, with 82.1% females. Median (range) scores were 5 (1-10), 4 (1-10), and 2 (1-10) for facial pain/pressure, congestion, and mucus, respectively. Patients had significant day-to-day fluctuations in scores for all three symptoms, with a significant positive correlation between symptoms (congestion/mucus (r = 0.61, P < 0.0001), congestion/facial pain (r = 0.56, P < 0.0001), and mucus/facial pain (r = 0.44, P < 0.0001).

Conclusions: Patients with non-rhinogenic headache often have concurrent nasal symptoms, particularly congestion. Moreover, nasal congestion, mucus, and facial pain/pressure had significant correlations in terms of day-to-day fluctuations in severity. Our findings suggest that all three symptoms share a common neurogenic pathophysiology likely related to autonomic and sensory dysfunction of the nasal cavity.

    Presenting Author(s)

  • Avivah J. Wang, BS

    Medical Student
    Duke University
    Durham, North Carolina, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • RJ

    Rong Jiang, PhD

    Assistant Professor in Psychiatry and Behavioral Sciences
    Duke University, USA

    Disclosure information not submitted.

  • FG

    Frederick A. Godley, III, MD

    Otolaryngologist
    University Otolaryngology
    Providence, RI, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Ralph Abi Hachem, MD

    MD
    Duke University
    Durham, NC, United States

    Disclosure information not submitted.

  • Bradley J. Goldstein, MD, PhD

    Professor
    Duke University
    Durham, NC, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • DW

    David L. Witsell, MD

    Emeritus
    Duke University
    Chapel Hill, NC, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Senior Author(s)

  • David W. Jang, MD

    Associate Professor
    Duke University
    Durham, NC, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.