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Nose Surgery Shown to Help with Headaches

Functional nasal surgery relieves chronic headache for some patients

Nasal surgery to relieve obstructed breathing can reduce or eliminate chronic headaches in selected patients, according to a paper in the December issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).

At lease partial improvement in their headaches were seen by 85% of patients undergoing functional nasal surgery, according to research by Ahmed M. Afifi, MD, and colleagues of University of Wisconsin, Madison. “These results suggest that the use of nasal surgery to improve headache symptoms is a viable treatment option in appropriately selected chronic headache patients,” the researchers said.

Nasal surgery improves headache by addressing ‘contact points’

The researchers analyzed evidence from previous studies of nasal surgery to treat chronic headache. These procedures target “contact points” within the nose and sinuses, which are believed to serve as trigger points for chronic headaches. This type of surgery is often done as part of functional nasal surgery to relieve obstructed breathing. Functional nasal surgery has been shown to improve nasal airway breathing, allergy symptoms and obstructive sleep apnea.

A systematic research review identified 39 studies reporting on 1,577 patients who underwent functional nasal surgery for treatment of headaches due to mucosal contact points. The most common procedures were surgery to address a deviated septum or excess sinus tissue. About half of the studies included endoscopic sinus surgery (ESS), often performed in patients with recurrent sinus infections.

The data suggested that functional nasal surgery was highly effective in reducing or eliminating chronic headache symptoms. About 48% of patients reported that their headaches were cured after surgery, while another 37% had significant improvement in headache severity or frequency. Only 15% reported no change.

In a subset of studies, functional nasal surgery reduced the number of days with headache from approximately 22 to 6 days per month. Ratings of headache pain were also significantly reduced.

“Taken together, these results underscore the importance of a thorough diagnostic workup to help tailor individualized surgical treatment to each patient’s unique anatomy,” the researchers write. But they emphasize that the specific procedures performed in the studies varied substantially, as well as the need for consistent diagnostic criteria to identify chronic headache patients who might benefit from functional nasal surgery.

“Functional nasal surgery is a viable option to improve headache symptoms in appropriately selected patients,” Dr. Afifi and colleagues conclude. They highlight the need for well-controlled randomized trials, including careful selection criteria to identify patients most likely to benefit from this surgical approach to treatment for chronic headache.

Source: American Society of Plastic Surgeons

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