It seems that for some migraine sufferers, their headaches are caused - or at least worsened - when opposite surfaces within sinuses or nasal cavities touch. Now researchers have shown that surgical correction of these contact points can bring substantial relief for some such patients.
“We are very excited and think this procedure will change the course of treatment for migraine sufferers and other headache patients,” said lead researcher Dr. Fereidoon Behin.
Intranasal contact points are believed to lead to the phenomenon of referred pain, in the trigeminal nerve.
In fact, as Behin and colleagues note in the medical journal Cephalalgia, “mucosal contact headache is a newly added secondary headache disorder in the International Classification of Headache Disorders.”
Behin, at Christ Hospital in Jersey City, New Jersey, and colleagues evaluated 21 patients who had severe migraines that didn’t respond to conventional treatment. All of the participants had intranasal contact points that could be seen on CT scans.
Also, when these contact points were treated with an anesthetic lotion, all the patients experienced a temporary reprieve in their headaches. They then underwent endoscopic surgery to correct the contact areas
In the months after the surgery, the average number of days with headache experienced by the group fell from 18 to 8 days per month.
The average headache severity, measured on a 10-point scale, dropped from 7.8 to 5.6. Similarly, headache-related disability fell from 5.6 to 1.8.
In all, 18 patients had their headache scores improved by 25 percent or more. One patient had a reduction of less than 25 percent and the remaining two had an increase in their headache score of less than 25 percent.
Altogether, nine subjects were pain-free at their last follow-up evaluation.
The researchers call for more studies, but conclude that for migraine patients with contact points seen on a CT scan, “surgery appears to improve outcomes.”
SOURCE: Cephalalgia, June 2005.
Revision date: July 6, 2011
Last revised: by Jorge P. Ribeiro, MD