Impact of corrective rhinologic surgery on rhinogenic headache

Abstract

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.