Investigation of diagnosis and surgical treatment of mucosal contact point headache.
We aimed to investigate the differences in incidence of nasal anatomic abnormalities between patients with and without headache and the outcome of surgical treatment for the headache patients with mucosal contact points. We conducted the observational study and recruited 107 subjects without headache (nonheadache group) and 78 patients with recurrent headache for more than 2 years (headache group). Study participants underwent high-resolution sinus computed tomography scans, and the incidence of nasal anatomic abnormalities was calculated in both groups. An additional 25 patients with recurrent headache underwent endoscopic surgical treatment. Mucosal contact points were observed in 85.9% of patients with recurrent headache and also in 80.4% of participants without headache. The most common mucosal contact point was between a deviated nasal septum and lateral nasal wall (41.1%). The incidence of deviated nasal septum contacting with lateral nasal wall was significantly different between the headache group (55.1%) and the nonheadache group (40.2%) (p < 0.05). The postoperative pain scores of the additional 25 headache patients with recurrent headache and mucosal contact point who were treated with endoscopic surgery decreased significantly compared with their preoperative measurements (p < 0.001), but only 44% of patients had recovered from headache 7 days postoperatively. We conclude that some patients with recurrent headache may not have a mucosal contact point, and some patients with mucosal contact points may not meet the diagnostic criteria of mucosal contact point headache since pain was not resolved within 7 days after surgical treatment. The diagnostic criteria of mucosal contact point headache before surgery should be reevaluated.
Department of Otolaryngology Head and Neck Surgery, Beijing Shijitan Hospital, Tieyi Road 10#, Haidian District, Beijing, China 100038. yinjinshu55@aliyun.com.
Jia
J
Wang
Jin-Shu
JS
Yin
Hong
H
Peng
D000328:Adult; D016022:Case-Control Studies; D000013:Congenital Abnormalities / Q000453:epidemiology* / Q000601:surgery; D005260:Female; D006261:Headache / Q000453:epidemiology*; D006801:Humans; D008297:Male; D009297:Nasal Mucosa; D009300:Nasal Septum / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D010256:Paranasal Sinuses / Q000002:abnormalities* / Q000000981:diagnostic imaging; D012008:Recurrence; D014057:Tomography, X-Ray Computed; D014420:Turbinates / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery