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Endonasal mucosal contact points in chronic migraine

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Abstract

Some anatomo-functional alterations of the nose may be considered as possible causes of headache: deviations of the nasal septum, abnormal turbinates, especially middle or superior, with consequent areas of mucosal contact with the septum. This study was performed on 100 subjects, 27 chronic migraine (CM) sufferers and 73 subjects who never suffered from migraine as control group. In the CM group, a direct endoscopic assessment was carried out in order to search for mucosal points of contact. Following the endoscopy, the patients underwent a computerized tomography (CT) in order to confirm the mucosal contact and for a better evaluation of its localization. The control group (C group) consisted of subjects who underwent a CT of the skull for various reasons. In CM group, a mucosal contact was highlighted in 14 patients (51.8 %); it was unilateral in 50 % of cases. In C group, the contact was present in 27 cases (36.9 %); in 81.5 % of them (n = 22), it was unilateral. A single site of contact was present in 6 (22 %) patients in CM group and 20 (27.3 %) patients in C group; more sites, in 8 (29.6 %) CM group patients and in 7 (9.5 %) patients of the C group. The connection between subjects and the number of single or multiple contacts in the two groups was statistically significant (p = 0.049). Furthermore, the frequency of the septum–middle turbinate was significantly (p = 0.0013) more frequent in CM sufferers (13/14) compared with control subjects (11/27). This study suggests, although with extremely early data, the need to select carefully patients for a possible surgical approach, using various parameters: in particular, the site of the mucosal contact, favoring the cases with multiple areas of contact, mainly between septum–middle turbinate and septum–superior turbinate.

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Abbreviations

CM:

Chronic migraine

CT:

Computerized tomography

References

  1. Lipton RB (2011) Chronic migraine, classification, differential diagnosis, and epidemiology. Headache 51(S2):77–83

    Article  PubMed  Google Scholar 

  2. Natoli JL, Manack A, Dean B, Butler Q, Turkel CC, Stovner L, Lipton RB (2010) Global prevalence of chronic migraine: a systematic review. Cephalalgia 30(5):599–609

    CAS  PubMed  Google Scholar 

  3. Sluder G (1927) Vacuum frontal headaches with eyes symptoms only. In: Sluder G (ed) Nasal Neurology. Headaches and eye disorders, Mosby, St. Louis, pp 31–67

    Google Scholar 

  4. Stammberger H, Wolf G (1988) Headaches and sinus disease: the endoscopic approach. Ann Otol Rhinol Laryngol Suppl 134:3–23

    CAS  PubMed  Google Scholar 

  5. Bieger-Farhan AK, Nichani J, Willatt DJ (2004) Nasal septal mucosal contact points: associated symptoms and sinus CT scan scoring. Clin Otolaryngol Allied Sci 29:165–168

    Article  CAS  PubMed  Google Scholar 

  6. Mudgil SP, Wise SW, Hopper KD et al (2002) Correlation between presumed sinus-induced pain and paranasal sinus computed tomographic findings. Ann Allergy Asthma Immunol 88:223–226

    Article  PubMed  Google Scholar 

  7. Headache Classification Subcommittee of the International Headache Society (2004) The International classification of headache disorders: 2nd edn. Cephalalgia 24(Suppl. 1):9–169

    Google Scholar 

  8. Headache Classification Committee of the International Headache Society (2013) The International classification of headache disorders, 3rd edition (beta version). Cephalalgia 33(9):629–808

    Article  Google Scholar 

  9. Abu-Bakra M, Jones NS (2001) The prevalence of nasal mucosal contact points in patients with facial pain compared with patients without facial pain. J LaryngolOtol 115:629–632

    CAS  Google Scholar 

  10. Kunachak S (2002) Middle turbinate lateralization: a simple treatment for rhinologic headache. Laryngoscope 112:870–872

    Article  PubMed  Google Scholar 

  11. Parsons DS, Batra PS (1998) Functional endoscopic sinus surgical outcomes for contact point headaches. Laryngoscope 108:696–702

    Article  CAS  PubMed  Google Scholar 

  12. Sindwani R, Wright ED (2003) Role of endoscopic septoplasty in the treatment of a typical facial pain. J Otolaryngol 32:77–80

    Article  PubMed  Google Scholar 

  13. Tosun F, Gerek M, Ozkaptan Y (2000) Nasal surgery for contact point headaches. Headache 40:237–240

    Article  CAS  PubMed  Google Scholar 

  14. Onerci M, Haberal L, Rinojenik agri (1999) In: Onerci M, Sinuzit (eds) Kutsan Offset, Ankara, Turkey, pp 89–94

  15. Landrigan GP, Kirkpatrick DA (1992) Intranasal xylocaine: a prognostic aid for pre-operative assessment of facial pain of nasal origin. J Otolaryngol 21:126–128

    CAS  PubMed  Google Scholar 

  16. Clerico DM (1996) Pneumatized superior turbinate as a cause of referredmigraine headache. Laryngoscope 106:874–879

    Article  CAS  PubMed  Google Scholar 

  17. Giacomini PG, Alessandrini M, De Padova A (2003) Septoturbinal surgery in contact point headache syndrome: long-term results. Cranio 21:130–135

    PubMed  Google Scholar 

  18. Behin F, Behin B, Bigal ME (2005) Surgical treatment of patients with refractory migraine headaches and intranasal contact points. Cephalalgia 25:439–443

    Article  CAS  PubMed  Google Scholar 

  19. Baranuik JN, Lundgren JD, Okayama M (1991) Substance P and neurokinin A in human nasal mucosa. Am J Respir Cell MolBiol 4:228–236

    Article  Google Scholar 

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All the authors certify that there is no actual or potential conflict of interest in relation to this article.

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Authors and Affiliations

  1. ENT Department, Gradenigo Hospital, Corso Regina Margherita 8/10, 10110, Turin, Italy

    V. Ferrero & T. Pozzo

  2. Department of Surgical Sciences, Women’s Headache Center, University of Turin, Turin, Italy

    G. Allais, S. Rolando & C. Benedetto

  3. Department of Economics, Social Studies, Applied Mathematics and Statistics, University of Turin, Turin, Italy

    R. Allais

Authors
  1. V. Ferrero
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  2. G. Allais
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  3. S. Rolando
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  4. T. Pozzo
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  5. R. Allais
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  6. C. Benedetto
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Correspondence to V. Ferrero.

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Ferrero, V., Allais, G., Rolando, S. et al. Endonasal mucosal contact points in chronic migraine. Neurol Sci 35 (Suppl 1), 83–87 (2014). https://doi.org/10.1007/s10072-014-1749-x

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  • DOI: https://doi.org/10.1007/s10072-014-1749-x

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