Long-lasting airplane headache in a patient with chronic rhinosinusitis

Abstract

The authors report long-lasting airplane headache in a patient with non-allergic, chronic rhinosinusitis. Association of mucosal inflammation with compromised sinonasal ventilation and sinus barotrauma created a base for not only the pain but also for the prolongation of symptoms. Effective therapy with antihistamine and nasal decongestant supports the theory that sinonasal barotrauma plays a triggering role in the pathophysiology of airplane headache.

Airplane headache in pediatric age group: report of three cases

“…Pfund et al have suggested that impaired sinonasal ventilation and sinus barotrauma due to mucosal inflammation create a base for not only the AH, but also for the prolongation of symptoms. Effective therapy with antihistamine and nasal decongestant supports the theory that sinonasal barotrauma plays a triggering role in the pathophysiology of AH [6]. Our first case also confirms this theory.…”

Headache attributed to airplane travel: diagnosis, pathophysiology, and treatment – a systematic review

“… • The authors stated that their effective treatment with antihistamine and anti-inflammatory medications support the theory that sinus barotrauma plays a central role in the mechanism of AH. 2010, Pfund et al [ 19 ] 1 1 F 27 Case report • The patient developed bilateral headache located in her ear, cheek, forehead, and on the top of the head. The pain was described as stabbing, jabbing and rated as 10/10.…”

“… • The authors supported the hypothesis of sinus barotrauma as a possible mechanism of AH. 2011, Mainardi et al [ 29 ] N/A N/A N/A Letter to the editor • The authors stated that the findings from the paper by Pfund et al [ 19 ] differ from the stereotypical AH-attacks: 1) The AH-attack does not exceed 30 min, 2) the pain is not strictly bilateral and 3) neuroradiological examinations do not show signs of sinus inflammation. • They suggested that “pure” AH should be considered as a separated headache from the flight-related headache in patients with organic condition.…”

The Plane Headache: A Frequent but Little Known Entity

“…7 In light of the literature, it has been observed that this pathology is related to sinus barotraumas, alterations in its pressure, personal history of acute or chronic sinusitis or allergies. 8 In 2012, Mainardi et al 9 performed a study with 75 patients where it was observed that the disease was more common in men (61.3%) over 35 years of age without symptoms in the first flight (88%). The predominant clinical was hemicranial headache (86.5%) fronto-orbital (76.7%), "hammering" (70.3%) and shorter than 30 minutes (95.8%) being the most frequent 10-20 minutes (58.3%).…”