Patterns of Migraine Disease in Otolaryngology: A CHEER Network Study. (July 2018)

• Record Type: Journal Article
• Authors: Schulz, Kristine A.; Esmati, Elnaz; Godley, Frederick A.; Hill, Claude L.; Monfared, Ashkan; Teixido, Michael; Tucci, Debara L.; Witsell, David L.
• Is Part Of: Otolaryngology--head and neck surgery. Volume 159:Number 1(2018)
• Page Start: 42
• Page End: 50
• Publication Date: 2018-07
• Subjects: migraine -- headache -- Ménière's disease -- sinusitis -- dizziness -- rhinosinusitis -- vestibular migraine -- benign paroxysmal positional vertigo -- sinus headache -- CHEER; Head -- Surgery -- Periodicals; Neck -- Surgery -- Periodicals; Otolaryngology -- Periodicals; 617.51
• DOI: 10.1177/0194599818764387
• Languages: English
• ISSNs: 0194-5998

Abstract

Objective: To evaluate the prevalence of migraine disease in an otolaryngologic cohort and migraine-related otologic and sinonasal symptoms in this population. Study Design: Cross-sectional study utilizing the CHEER (Creating Healthcare Excellence through Education and Research) network for recruitment. Setting: Patients were recruited in a cross-sectional and pragmatic manner in 14 CHEER sites between June 2015 and March 2017 (9 academic, 5 community based). Subjects and Methods: Patients were included if they were aged ≥18 years and seen for any concern that was not head and neck cancer. Patients with any history of brain abnormality or headaches that began within 2 weeks of a medical illness, trauma, or head injury were excluded. Patients were screened for migraine with a validated instrument. If they screened positive on the Migraine Assessment Tool (MAT+), the subjects also filled out validated and custom questionnaires for sinonasal, otologic, and migraine-specific symptoms. Results: Of 1458 patients screened, 235 (16.1%) screened positive for migraine (MAT+), which is higher than general population (13%, P < .001). The MAT+ group was significantly younger (47.2 vs 55.6 years of age, P < .001) and predominantly women (80.0% vs 55.9%, P < .001). The MAT+ cohort commonly reported ear- and sinus-related symptoms, such as tinnitus (70.5%), ear pressure (61.9%), balance problems (82%), facial pressure (85%), and rhinorrhea (49.9%). There were significantly higher levels of sinus burden with higher levels of dizziness handicap, Jonckheere-Terpstra test = 11, 573.00, z = 7.471, P < .001. Conclusion: Migraine disease has a higher prevalence in an otolaryngologic cohort than in the general population, presenting with a high rate of sinonasal and otologic symptoms that may be due to or exacerbated by migraines.