title: Migraine: A look down the nose.
abstract: BACKGROUND
  Studies have suggested that contact between opposing mucosal surfaces in the nasal wall and cavity can be a target of the surgical treatment of migraines. Unfortunately, not enough is known about the role of nasal pathology in the pathogenesis of this condition. The co-existence of further rhinological disorders can be an impediment to defining the cause and effect of anatomical variants. The authors compared the MRI scans of migraine- and non-migraine patients (MPs and NMPs, respectively) to determine the prevalence of such mucosal contact points in order to extrapolate whether there is a significant association with migraines.
  
  
  METHODS
  Coronal and axial MRI brain scans of 522 patients (412 migraineurs and 110 non-migraineurs) were analysed for the prevalence of anatomical variations of the nasal cavity, e.g. concha bullosa, septal deviations, mucosal swelling and contact points.
  
  
  RESULTS
  The results showed no significant difference between MPs and NMPs patients for any of the parameters examined. Moreover, 87% MPs and 79% NMPs had at least one contact point. The most frequent contact point was between the middle turbinate and the septum, observed in 54% of MPs and 45% of NMPs.
  
  
  CONCLUSIONS
  Contact points with the nasal mucosa are highly prevalent in both MPs and NMPs. Although a contact point does not cause a migraine in the absence of the disease, the concomitant presence of migraine and contact points can trigger an attack, and therefore, it is necessary to differentiate or exclude a rhinological disorder in these patients.
authors.affiliation: Migraine Surgery Centre, 10 Harley Street, London W1G 9PF, United Kingdom. Electronic address: muehlberger@migrainesurgery.co.uk.
authors.forename: Thomas
authors.initials: T
authors.lastname: Muehlberger
authors.affiliation: Department of Plastic and Reconstructive Surgery, Royal Free Hospital NHS Trust, Pond Street, London NW3 2QG, United Kingdom.
authors.forename: Justin C R
authors.initials: JCR
authors.lastname: Wormald
authors.affiliation: Department of Plastic and Reconstructive Surgery, Royal Free Hospital NHS Trust, Pond Street, London NW3 2QG, United Kingdom.
authors.forename: Nadine
authors.initials: N
authors.lastname: Hachach-Haram
authors.affiliation: Department of Plastic and Reconstructive Surgery, Royal Free Hospital NHS Trust, Pond Street, London NW3 2QG, United Kingdom.
authors.forename: Afshin
authors.initials: A
authors.lastname: Mosahebi
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000000981:diagnostic imaging* / Q000209:etiology; D009296:Nasal Cavity / Q000002:abnormalities / Q000000981:diagnostic imaging; D009297:Nasal Mucosa / Q000002:abnormalities / Q000000981:diagnostic imaging*; D009300:Nasal Septum / Q000002:abnormalities / Q000000981:diagnostic imaging; D059906:Neuroimaging; D009666:Nose / Q000002:abnormalities / Q000000981:diagnostic imaging; D012307:Risk Factors; D014420:Turbinates / Q000002:abnormalities / Q000000981:diagnostic imaging
keywords: Headache; Migraine; Migraine surgery; Rhinology