Endonasal surgery for contact point headaches: a 10-year longitudinal study.
Laryngoscope
; 113(12): 2151-6, 2003 Dec.
Article
en En
| MEDLINE
| ID: mdl-14660919
ABSTRACT
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. STUDYDESIGN:
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.
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Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Nariz
/
Cefalalgia Histamínica
/
Trastornos Migrañosos
Tipo de estudio:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
Límite:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Laryngoscope
Asunto de la revista:
OTORRINOLARINGOLOGIA
Año:
2003
Tipo del documento:
Article
País de afiliación:
Suiza