Endonasal Surgery for Contact Point Headaches: A 10‐Year Longitudinal Study

Welge‐Lüessen, Antje; Häuser, Roman; Schmid, Nevenka; Kappos, Ludwig; Probst, Rudolf

doi:10.1097/00005537-200312000-00019

Cited by 69 publications

(54 citation statements)

References 24 publications

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“…Twenty patients with refractory cluster headache or migraine, selected after demonstrated failure of several standard preventive treatments, were followed up for a maximum of 10 years after surgery. Six patients remained completely free of pain, seven had significant symptom improvement, and seven received no benefit from surgery (65% improvement) [21]. In another study by Behin et al [22] on surgical treatment of nasal contact point in patients with refractory chronic migraine, they concluded that, if contact points are present and headache responds to local anesthesia, surgery appears to improve the outcomes.…”

Section: Discussionmentioning

confidence: 96%

The outcomes for nasal contact point surgeries in patients with unsatisfactory response to chronic daily headache medications

Abu-Samra

Gawad

Agha

2011

Eur Arch Otorhinolaryngol

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The nasal contact point may act as a trigger point or peripheral enhancer in patients with chronic daily headaches. A total of 42 patients had unsatisfactory response to medical treatment for chronic daily headache with radiologic evidence of nasal contact point. Of them, 12 (28.5%) patients were positive for the local anesthetic test. Those patients were operated upon to separate this contact by either septoplasties or submucous resections with or without partial turbinectomies. The mean headache frequency was reduced from 22 to 7 days/month. The mean headache severity was reduced from 5.6 to 2.4. Eight (19%) patients became completely free from headache and its medications, six (75%) of them were positive for local anesthetic test. The patients were satisfied with postoperative monotherapy, or headache severity and frequency could be tolerated without medications in 26 (62%) patients. There was no improvement in seven (16.6%) patients and only one patient (2%) became worse. The overall satisfaction was 83 and 81% for positive and negative anesthetic tests, respectively. The average monthly medication cost was reduced from $85 to 32. Nasal contact point surgery for chronic daily headache patients can satisfy them compared to previously unsatisfactory medications. Nasal contact point may contribute to potentiating or triggering chronic daily headache.

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Section: Discussionmentioning

confidence: 96%

The outcomes for nasal contact point surgeries in patients with unsatisfactory response to chronic daily headache medications

Abu-Samra

Gawad

Agha

2011

Eur Arch Otorhinolaryngol

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show abstract

“…Although we did not face any recurrence of complaints in our followups, the longevity of this treatment modality is a matter of debate. In a study by Welge-Luessen et al in the long-term follow-up, there could be some return of symptoms in a few patients after more than 7 to 8 years [12].…”

Section: Discussionmentioning

confidence: 91%

Septorhinoplasty as a treatment modality in refractory migraine headaches

et al. 2011

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Migraine headaches are fairly common among people throughout the world with many treatment modalities. The cornerstone of treatment has been traditionally medical treatment which is mostly symptomatic and needs to be repeated. A few surgical procedures have been proposed which eliminate the inciting factor, and septorhinoplasty is one of them. Between October 2001 and August 2004, 24 patients suffering from migraine headaches, underwent septorhinoplasty at 15th Khordad Hospital, Tehran, Iran. Our inclusion criteria were refractory migraine, contact points demonstrated by computed tomography scan, and significant headache improvement after topical anesthesia to the contact area. Reduced severity and frequency of migraine headaches were documented which is statistically significant (p<0.05). Septorhinoplasty in selected patients with contact points could reduce frequency, severity, and duration of migraine attacks.

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“…In 1997, Clerico et al [31] have reported results from 19 patients treated surgically for refractory primary headaches during a mean follow-up period of 21 months and the success rate was 79%. However, success rates of almost 90% have been reported for shorter follow-up periods of about 13 months [1,32,39], while after a follow-up period of 2 years, Welge-Luessen et al [34] showed an 85% success rate among their patients of which 60% were completely free of pain and 25% experienced a significant improvement. This rate decreased to 65%, with only six patients being free of symptoms after 10 years.…”

Section: Discussionmentioning

confidence: 98%

“…However, an incorrect surgical procedure that did not identify and remove the involved contact area cannot be excluded. Other factors, such as central modulation of pain may also be important [34].…”

Section: Discussionmentioning

confidence: 99%