Document Detail

Endonasal surgery for contact point headaches: a 10-year longitudinal study.
MedLine Citation:
PMID:  14660919     Owner:  NLM     Status:  MEDLINE    
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.
Antje Welge-Luessen; Rolf Hauser; Nevenka Schmid; Ludwig Kappos; Rudolf Probst
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Laryngoscope     Volume:  113     ISSN:  0023-852X     ISO Abbreviation:  Laryngoscope     Publication Date:  2003 Dec 
Date Detail:
Created Date:  2003-12-08     Completed Date:  2004-01-08     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  8607378     Medline TA:  Laryngoscope     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2151-6     Citation Subset:  IM    
Department of Otorhinolaryngology, University of Basel, Kantonsspital, Petersgraben 4, CH-4031 Basel, Switzerland.
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MeSH Terms
Cluster Headache / etiology,  surgery*
Ethmoid Bone / surgery
Ethmoid Sinus / surgery
Follow-Up Studies
Longitudinal Studies
Middle Aged
Migraine Disorders / etiology,  surgery*
Nasal Septum / surgery
Nose / surgery*
Patient Selection
Prospective Studies
Treatment Outcome
Turbinates / surgery

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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