{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T17:21:44Z","timestamp":1782321704460,"version":"3.54.5"},"reference-count":27,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2015,3,6]],"date-time":"2015-03-06T00:00:00Z","timestamp":1425600000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int Forum Allergy Rhinol"],"published-print":{"date-parts":[[2015,5]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The objective of this work was to study patient and 22\u2010item Sino\u2010Nasal Outcome Test (SNOT\u201022) characteristics in primary headache disorders (PHDs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective chart review of \u201csinus\u201d headache\/pressure\/pain patients was conducted. Patients that had rhinosinusitis excluded (negative endoscopy\/computed tomography [CT]), and neurologist\u2010confirmed PHD were studied. Patterns in symptom and SNOT\u201022 items were analyzed by network visualization and cluster analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty\u2010six patients met study criteria. Forty\u2010three (93.5%) reported \u201cneed to blow nose\u201d and 40 (86.9%) reported postnasal drainage. Sneezing was reported by 37 (80.4%) patients, \u201cblockage\/congestion of nose\u201d by 33 (71.8%), and \u201crunny nose by 32 (69.6%) patients. The median SNOT\u201022 score was 54 (interquartile range [IQR], 40 to 63). Past history included neurological diagnoses (60%), rhinologic disease (39%; chronic rhinosinusitis [CRS], rhinitis, recurrent acute sinusitis), asthma (28%), and allergen\u2010sensitivity (26%). Previous sinonasal surgery had been performed in 41%. Network layout and cluster analysis identified 2 patient clusters and 2 symptom clusters. Two\u2010thirds (31) of patients formed a tight cluster (cluster 1) linking to a symptom cluster of psychosocial items wrapped tightly with \u201cfacial pain\/pressure.\u201d The remaining one\u2010third of patients (cluster 2) linked to rhinologic symptoms loosely grouped away from \u201cfacial pressure\/pain.\u201d In contrast to patients in cluster 2, patients in cluster 1 were predominantly female (<jats:italic>p<\/jats:italic> &lt; 0.04), had significantly higher (<jats:italic>p<\/jats:italic> &lt; 0.0001) median SNOT\u201022 scores (60 vs 34; IQR, 53 to 67 vs 17 to 42), were more likely to have migraine history (<jats:italic>p<\/jats:italic> = 0.058), and reported being \u201csad\u201d (<jats:italic>p<\/jats:italic> &lt; 0.0001) or \u201cembarrassed\u201d (<jats:italic>p<\/jats:italic> &lt; 0.006).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Prominent rhinologic symptoms can be present in PHD patients in the absence of rhinosinusitis. In particular, high symptom\u2010burden\/SNOT\u201022 scores and high psychosocial symptoms should raise suspicion of PHD when endoscopy and\/or CT results do not correlate with symptoms.<\/jats:p><\/jats:sec>","DOI":"10.1002\/alr.21502","type":"journal-article","created":{"date-parts":[[2015,3,6]],"date-time":"2015-03-06T14:09:50Z","timestamp":1425650990000},"page":"408-416","source":"Crossref","is-referenced-by-count":36,"title":["Clinical and 22\u2010item Sino\u2010Nasal Outcome Test symptom patterns in primary headache disorder patients presenting to otolaryngologists with \u201csinus\u201d headaches, pain or pressure"],"prefix":"10.1002","volume":"5","author":[{"given":"Devyani","family":"Lal","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Mayo Clinic  Phoenix AZ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexis B.","family":"Rounds","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Mayo Clinic  Phoenix AZ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew A.","family":"Rank","sequence":"additional","affiliation":[{"name":"Division of Allergy, Asthma, and Clinical Immunology Mayo Clinic  Phoenix AZ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohit","family":"Divekar","sequence":"additional","affiliation":[{"name":"Division of Allergic Diseases Mayo Clinic  Rochester MN"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,3,6]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.132.7.748"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0030-6665(03)00181-6"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1526-4610.2001.041007646.x"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4610.2006.00688.x"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2007.06.726"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlg.0000224508.59725.19"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.23385"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.20084"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.164.16.1769"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2004.01.005"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2005.07.005"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-2982.2009.01877.x"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/0333102413512031"},{"issue":"256","key":"e_1_2_6_15_1","first-page":"1","article-title":"Summary Health Statistics for U.S. adults: National Health Survey, 2011","author":"Schiller JS","year":"2012","journal-title":"Vital Health Stat 10"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-4486.2009.01995.x"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1067\/mhn.2002.121022"},{"key":"e_1_2_6_18_1","doi-asserted-by":"crossref","unstructured":"BastianM HeymannS JacomyM.Gephi: an open source software for exploring and manipulating networks. 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