Impact of Corrective Rhinologic Surgery on Rhinogenic Headache

Objective In this study, the localization of the headache, mucosal contact points, sinonasal anatomic variations and the incidence of mucosal abnormalities were determined in patients with rhinogenic headache, and the efficacy of the corrective surgery on the severity of the headache and the rate of improvement on that localization were investigated. Study Design Conducted in a prospective manner. Level of Evidence Level 2b. Methods Sixty-five patients who were admitted with sinonasal symptoms and headache and had septoplasty, endoscopic sinus surgery, or surgical procedures involving the nasal turbinates were included in this study. The quality and the severity of the headache were investigated preoperatively as well as in the 3rd and 12th postoperative months. Results Headache was most frequently localized the frontal region. The mucosal contact points were most frequently localized between the nasal septum and the middle or inferior turbinates. Differences between preoperative headache and headache in postoperative 3rd month and postoperative 12th month were statistically significant (P < 0.05). Improvement in headache after surgery was statistically significant in cases with Haller cell and paradoxical middle turbinate and in patients with contact points between the nasal septum and the middle or inferior turbinates (P < 0.05). Conclusions We have shown the importance of surgery in the treatment of rhinogenic headache. We have also shown the reliability of the decongestion test for determining the indication for surgery. We suggest that the rhinologic surgery may have a great contribution to the treatment of headache.

[1]  M. Ash.  Occlusion, TMDs, and dental education , 2007, Head & face medicine.

[2]  A. Daudia,et al.  Paranasal Sinus Pathologies in Patients Presenting with Headache as the Primary Symptom , 2006, Cephalalgia : an international journal of headache.

[3]  Hong Cy,et al.  Paranasal Sinus Pathologies in Patients Presenting with Headache as the Primary Symptom , 2006 .

[4]  S. Baredes,et al.  Surgical Management of Contact Point Headaches , 2005, Headache.

[5]  M. Senocak,et al.  Sinonasal pathology and headaches. , 2004, Rhinology.

[6]  L. Kappos,et al.  Endonasal Surgery for Contact Point Headaches: A 10‐Year Longitudinal Study , 2003, The Laryngoscope.

[7]  N. Jones,et al.  Prevalence of nasal mucosal contact points in patients with facial pain compared with patients without facial pain , 2001, The Journal of Laryngology & Otology.

[8]  N. Jones,et al.  Endoscopy‐Negative, Computed Tomography‐Negative Facial Pain in a Nasal Clinic , 2001, The Laryngoscope.

[9]  J. Medlin.  NIEHS trainees: hail fellows, well met. , 2001, Environmental health perspectives.

[10]  M. Gerek,et al.  Nasal Surgery for Contact Point Headaches , 2000, Headache.

[11]  David S. Parsons,et al.  Functional Endoscopic Sinus Surgical Outcomes for Contact Point Headaches , 1998, The Laryngoscope.

[12]  J. Piccirillo,et al.  Relationship between patient-based descriptions of sinusitis and paranasal sinus computed tomographic findings. , 1997, Archives of otolaryngology--head & neck surgery.

[13]  D. Grabo,et al.  Endoscopic sinonasal surgery in the management of primary headaches. , 1997, Rhinology.

[14]  D. Clerico.  Pneumatized Superior Turbinate as a Cause of Referred Migraine Headache , 1996, The Laryngoscope.

[15]  H. Wanamaker.  Role of Haller's Cell in Headache and Sinus Disease: A Case Report , 1996, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[16]  D. Clerico.  Sinus Headaches Reconsidered: Referred Cephalgia of Rhinologic Origin Masquerading as Refractory Primary Headaches , 1995, Headache.

[17]  J. Chow.  Rhinologic Headaches , 1994, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[18]  Landrigan Gp,et al.  Intranasal Xylocaine: a prognostic aid for pre-operative assessment of facial pain of nasal origin. , 1992 .

[19]  G. Landrigan,et al.  Intranasal Xylocaine: a prognostic aid for pre-operative assessment of facial pain of nasal origin. , 1992, The Journal of otolaryngology.

[20]  H. Stammberger,et al.  Headaches and Sinus Disease: The Endoscopic Approach , 1988, The Annals of otology, rhinology & laryngology. Supplement.

[21]  T. Fry,et al.  Headache of Nasal Spur Origin: an Easily Diagnosed and Surgically Correctable Cause of Facial Pain , 1984, Headache.

[22]  K. M. Morgenstein,et al.  Experiences in middle turbinectomy , 1980, The Laryngoscope.