Endonasal Surgery for Contact Point Headaches: A 10-Year Longitudinal Study
Article first published online: 3 JAN 2009
Copyright © 2003 The Triological Society
Volume 113, Issue 12, pages 2151–2156, December 2003
How to Cite
Welge-Luessen, A., Hauser, R., Schmid, N., Kappos, L. and Probst, R. (2003), Endonasal Surgery for Contact Point Headaches: A 10-Year Longitudinal Study. The Laryngoscope, 113: 2151–2156. doi: 10.1097/00005537-200312000-00019
- Issue published online: 3 JAN 2009
- Article first published online: 3 JAN 2009
- Manuscript Accepted: 2 JUL 2003
- Endonasal contact point;
Objective Some migraine and cluster headaches may be triggered by stimulation of intranasal contact points via the trigeminovascular system. Endonasal surgery is successful in some patients, but long-term outcomes have not been reported.
Study Design Prospective
Methods This investigation included 20 patients with a mean 18-year history of refractory cluster or migraine headaches who were selected for surgery. All had endoscopically visible endonasal contact as well as a positive preoperative cocaine test result. Changes in pain severity and frequency and duration of headache attacks were statistically rated using a MANOVA. Follow-up averaged 112 months.
Results Almost 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). Two patients had been free of all symptoms for 7 and 8 years, respectively, before complaints returned.
Conclusion Our data suggest that some patients with refractory headaches and endonasal contact areas benefit from surgery, thereby supporting the existence of a connection between the two. Even though it is clear that surgery should be considered only if all other treatments have failed, a success rate of 65% over almost 10 years justifies evaluation of this option. Preoperative patient selection remains crucial and warrants further investigation.