Rhinogenic headache caused by concha bullosa mucopyocele, an unusual origin. Case Report

Main Article Content

Shirley Andrea Ramirez Merlano
Nelson Delgado
Diana Cortes

Abstract

Introduction: rhinogenic headache is secondary to permanent contact with the nasal mucosa and may be secondary to concha bullosa, if infected it may be mucocele or mucopiocele. Clinical case: 34-year-old patient with left hemicranial headache, ipsilateral periocular pain, congestion, and hyaline rhinorrhea with changes in consistency and coloration of the mucus. In the computed tomography (CT) of the paranasal sinuses (SPN) right septal deviation due to left concha bullosa, fluid occupation. Mucocele and secondary rhinogenic headache were suspected, lidocaine test positive. Eikenella corrodens was detected by culture. Management with antibiotics and subsequent resolution of pathology. Conclusions: nasal endoscopy and SPN CT should be included in the differential diagnosis of headache and concha bullosa. Surgical management has been shown to reduce headache intensity and frequency in the short and long term, and is successful if there is a positive lidocaine test.

Downloads

Download data is not yet available.

Article Details

How to Cite
1.
Ramirez Merlano SA, Delgado N, Cortes D. Rhinogenic headache caused by concha bullosa mucopyocele, an unusual origin. Case Report. Acta otorrinolaringol cir cabeza cuello [Internet]. 2023Jul.14 [cited 2024Dec.22];51(2):155 - 19. Available from: https://revista.acorl.org.co/index.php/acorl/article/view/700
Section
Reportes de Casos

References

Bernichi JV, Rizzo VL, Villa JF, Santos RF, Caparroz FA. Rhinogenic and sinus headache - Literature review. Am J Otolaryngol. 2021;42(6):103113. doi: 10.1016/j. amjoto.2021.103113

Khalife S, Marchica C, Zawawi F, Daniel SJ, Manoukian JJ, Tewfik MA. Concha bullosa mucocele: A case series and review of the literature. Allergy Rhinol (Providence). 2016;7(4):233- 43. doi: 10.2500/ar.2016.7.0179

Shihada R, Luntz M. A concha bullosa mucopyocele manifesting as migraine headaches: a case report and literature review. Ear Nose Throat J. 2012;91(5):E16-8. doi: 10.1177/014556131209100518

Mokbel KM, Abd Elfattah AM, Kamal el-S. Nasal mucosal contact points with facial pain and/or headache: lidocaine can predict the result of localized endoscopic resection. Eur Arch Otorhinolaryngol. 2010;267(10):1569-72. doi: 10.1007/ s00405-010-1245-8

Al-Sebeih KH, Bu-Abbas MH. Concha bullosa mucocele and mucopyocele: a series of 4 cases. Ear Nose Throat J. 2014;93(1):28-31.

Cohen SD, Matthews BL. Large concha bullosa mucopyocele replacing the anterior ethmoid sinuses and contiguous with the frontal sinus. Ann Otol Rhinol Laryngol. 2008;117(1):15-7. doi: 10.1177/000348940811700104

Bakheet E, Bakheet T. Prevalence of Anatomical Abnormalities of Nose & Paranasal Sinuses in Cases of Rhinogenic Headache Among Sohag University Students. SMJ. 2019;24(1):140-49. doi: 10.21608/SMJ.2019.16715.1056

Sari K, Gencer ZK, Kantekin Y. Concha Bullosa Mucopyocele: a Case Report. Acta Medica (Hradec Kralove). 2015;58(4):147- 9. doi: 10.14712/18059694.2016.8

Oakley G, Wiggins R, Error M, Meier J. Radiology Quiz Case 2: Diagnosis. JAMA Otolaryngol Head Neck Surg. 2013;139(1):96. doi:10.1001/jamaoto.2013.1159b

Abdel-Aziz M. Mucopyocele of the concha bullosa presenting as a large nasal mass. J Craniofac Surg. 2011;22(3):1141-2. doi: 10.1097/SCS.0b013e318210b95a

Roozbahany NA, Nasri S. Nasal and paranasal sinus anatomical variations in patients with rhinogenic contact point headache. Auris Nasus Larynx. 2013;40(2):177-83. doi: 10.1016/j. anl.2012.07.007

Sollini G, Mazzola F, Iandelli A, Carobbio A, Barbieri A, Mora R, et al. Sino-Nasal Anatomical Variations in Rhinogenic Headache Pathogenesis. J Craniofac Surg. 2019;30(5):1503- 505. doi: 10.1097/SCS.0000000000005239

Folic MM, Barac AM, Ugrinovic AB, Jotic AD, Trivic AS, Milovanovic JP, et al. Effectiveness of the Treatment of Rhinogenic Headache Caused by Intranasal Contact. Ear Nose Throat J. 2021:1455613211019706. doi: 10.1177/01455613211019706