title: Effect of turbinoplasty in concha bullosa induced rhinogenic headache, a randomized clinical trial.
abstract: BACKGROUND
  Rhinogenic origin is an important source for headache, which may be treated by medical or endoscopic intervention. An aim of this study was to clarify whether the surgical or medical intervention is superior.
  
  
  METHODS
  In this randomized double blind clinical trial study, 44 patients (19 male and 25 female) with periorbital or frontal pain were enrolled. Patients were divided into 2 groups of surgical or medical intervention randomly. Medical group received 3 courses of 1.5 months 125 μg per puff, fluticason nasal spray (2 puffs Q 24 hours in each side), and oral Pseudoephedrin 30 mg Q 8 hours with 2 weeks intervals. Surgical group underwent turbinoplasty with functional endoscopic sinus surgery approach. Duration (per hour), frequency (per week) and severities of the headaches were measured by Visual Analog Scale (VAS) before treatment, and at 1.5, 3 and 6 months after institution of treatment by an examiner, who was unaware of the patients' treatment plan.
  
  
  RESULTS
  Before treatment, chronicity (P = 0.980), severity (P = 0.742), frequency (P = 0.730), and duration (P = 0.603) of the headaches were not significantly different. The severities of the headaches in surgical group were significantly lower at 1.5, 3 and 6 months (P < 0.001), also the frequencies and the durations of the headaches were significantly lower at 6 months after an institution of treatment compared to medical group (P = 0.027, P = 0.008, respectively).
  
  
  CONCLUSIONS
  Turbinoplasty in chonca bullusa patients is an acceptable and a simple procedure for relieving pain in rhinogenic headaches, compared with medical treatment.
authors.affiliation: Associate Professor, Department of Otolaryngology, School of Medicine, Shahed University, Tehran, Iran.
authors.forename: Mohammad Ebrahim
authors.initials: ME
authors.lastname: Yarmohammadi
authors.forename: Hassan
authors.initials: H
authors.lastname: Ghasemi
authors.forename: Shahryar
authors.initials: S
authors.lastname: Pourfarzam
authors.forename: Mohammad Reza Jalali
authors.initials: MR
authors.lastname: Nadoushan
authors.forename: Siamak Afshin
authors.initials: SA
authors.lastname: Majd