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Endoscopic Management of Contact Point Headache in Patients Resistant to Medical Treatment

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Abstract

The existence and the best treatment for contact point headache is a controversial issue. Therefore, this study tried to evaluate the response of the patients with a rhinogenic headache who were resistant to medical treatment to endoscopic sinus surgery. Thirty patients who suffered from a unilateral headache or facial ache for at least 1 year and resistant to medical treatment were evaluated in this research. The existence of the contact point was confirmed in CT scan and in nasal endoscopy. Moreover, a positive Lidocaine test was another important factor for selecting patients. Endoscopic surgery was the common method of surgery in patients. After 1 year, the headache and nasal obstruction were assessed according to Visual Analogue Scale (VAS) and compared to preoperative VAS. In 30 patients who entered this research, the average headache and nasal obstruction score according to VAS was 7.4 ± 1.4 and 7.9 ± 2.5, respectively. These values consequently decreased to 4.8 ± 2.3 and 3.73 ± 1.7 1 year after surgery, respectively. The overall response rate was 93.3 % and no major complications were seen in this series. If there is strong clinical suspicion and meticulous selection criteria, provided that other causes of headache have been ruled out, endoscopic management of the rhinogenic headache can be effective.

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References

  1. Tosun F, Gerek M, Ozkaptan Y (2003) Nasal surgery for contact point headaches. Headache 40:237–240

    Article  Google Scholar 

  2. Parsons D, Batra P (1998) Functional endoscopic sinus surgical outcomes for contact point headaches. Laryngoscope 108:696–702

    Article  PubMed  CAS  Google Scholar 

  3. Kari E, DelGaudio J (2008) Treatment of sinus headache as migraine: the diagnostic utility of triptans. Laryngoscope 118:2235–2239

    Article  PubMed  CAS  Google Scholar 

  4. Cady R, Dodick D, Levine H (2005) Sinus headache: a neurology, otolaryngology, allergy, and primary care consensus on diagnosis and treatment. Mayo Clin Proc 80:908–916

    Article  PubMed  Google Scholar 

  5. Silberstein S (2004) Headaches due to nasal and paranasal sinus disease. Neurol Clin 22:1–19

    Article  PubMed  Google Scholar 

  6. Chow JM (1994) Rhinologic headaches. Otolaryngol Head Neck Surg 111:211–218

    Article  PubMed  CAS  Google Scholar 

  7. Schor D (1993) Headache and facial pain-the role of the paranasal sinuses: a literature review. Cranio 11:36–47

    PubMed  CAS  Google Scholar 

  8. Welge L, Rolf H, Schmid N (2003) Endonasal surgery for contact point headaches: a 10-year longitudinal study. Laryngoscope 113:2151–2156

    Article  Google Scholar 

  9. Curtis S, Susan H, Christopher W (2004) Prevalence of migraine in patients with a history of self-reported or physician-diagnosed “sinus” headache. Arch Intern Med 164:1769–1772

    Article  Google Scholar 

  10. Abu-Bakra M, Jones NS (2001) Prevalence of nasal mucosal contact points in patients with facial pain compared with patients without facial pain. J Laryngol Otol 115:629–632

    Article  PubMed  CAS  Google Scholar 

  11. Behin F, Behin B, Baredes S (2005) Surgical management of contact point headaches. Headache 45(3):204–210

    Article  PubMed  Google Scholar 

  12. Jones N (2009) Sinus headaches: avoiding over and misdiagnosis. Expert Rev Neurother 9:439–444

    Article  PubMed  Google Scholar 

  13. Mariotti LJ, Setliff RC, Ghaderi M, Voth S (2009) Patient history and CT findings in predicting surgical outcomes for patients with rhinogenic headache. Ear Nose Throat J 88:926–929

    PubMed  Google Scholar 

  14. Ramadan HH (1999) Nonsurgical versus endoscopic sinonasal surgery for rhinogenic headache. Am J Rhinol 13:455–457

    Article  PubMed  CAS  Google Scholar 

  15. Phillips J, Vowler S, Salam M (2007) Endoscopic sinus surgery for ‘sinus headache’. Rhinology 45:14–19

    PubMed  CAS  Google Scholar 

  16. Abu-Bakra M, Jones N (2001) Does stimulation of nasal mucosa cause referred pain to the face. Clin Otolaryngol Allied Sci 26:430–432

    Article  PubMed  CAS  Google Scholar 

  17. Mohebbi A, Memari F, Mohebbi S (2009) Endonasal endoscopic management of contact point headache and diagnostic criteria. Headache 50:242–248

    Article  PubMed  Google Scholar 

  18. Campos A, Solomons NB, Armengot M (1998) Role of nasosinusal endoscopic surgery in the treatment of headache and facial pain of rhinogenic origin. Acta Otorrinolaringol Esp 49:615–620

    PubMed  CAS  Google Scholar 

  19. Senocak D, Senocak M (2004) Sinonasal pathology and headaches. Rhinology 42:8–14

    PubMed  Google Scholar 

  20. Roger K, Curtis P (2009) Sinus problems as a cause of headache refractoriness and migraine chronification. Curr Pain Headache Rep 13:319–325

    Article  Google Scholar 

  21. Mehle M, Kremer P (2008) Sinus CT scan findings in “sinus headache” migraineurs. Headache 48:67–71

    PubMed  Google Scholar 

  22. Soler ZM, Mace J, Smith TL (2008) Symptom-based presentation of chronic rhinosinusitis and symptom-specific outcomes after endoscopic sinus surgery. Am J Rhinol 22:297–301

    Article  PubMed  Google Scholar 

Download references

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Authors and Affiliations

  1. Otolaryngology Department, Otolaryngology Research Center, Imam Khomeini Medical Center, Tehran University of Medical Sciences, Bagherkhan Street, Chamran Highway, 141973141, Tehran, Iran

    Mohammad Sadeghi & Babak Saedi

  2. Tehran University of Medical Sciences, Tehran, Iran

    Yasser Ghaderi

Authors
  1. Mohammad Sadeghi
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  2. Babak Saedi
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  3. Yasser Ghaderi
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Correspondence to Babak Saedi.

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Sadeghi, M., Saedi, B. & Ghaderi, Y. Endoscopic Management of Contact Point Headache in Patients Resistant to Medical Treatment. Indian J Otolaryngol Head Neck Surg 65 (Suppl 2), 415–420 (2013). https://doi.org/10.1007/s12070-013-0629-7

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  • DOI: https://doi.org/10.1007/s12070-013-0629-7

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