Behin Fereidoon, Behin Babak, Behin Daniel, Baredes Soly
Division of Otolaryngology, Christ Hospital, Jersey City, NJ 07306, USA
Headache. 2005 Mar;45(3):204-10. doi: 10.1111/j.1526-4610.2005.05045.x.
Contact point headaches are caused by contact between the nasal septum and the lateral nasal wall by a mechanism of referred pain involving the trigeminal nerve. Our goal was to investigate headaches caused by the contact between the septum and the superior turbinate or medial wall of the ethmoid sinuses and not the middle turbinate.
A retrospective chart review was performed on patients who underwent septoplasty and sinus surgery for headache. The total number of patients who opted for surgery was 23. Only 12 patients met the criteria of having a contact point between the septum and medial wall of the ethmoid sinus, or septum and superior turbinate, which were demonstrated via CT scan of the sinuses. These patients underwent surgical intervention in order to relieve the contact points.
According to the same pain questionnaire given pre- and postoperatively, 83% no longer complained of headaches, while 8% had significant relief. Forty-one percent of our patients were previously diagnosed with migraines; 80% of these patients were successfully treated by surgery.
Contact point headaches and migraine without aura (MWOA) have similar symptoms (eg, photophobia, phonophobia, nausea and vomiting, pulsating nature). We believe contact point headaches should be considered in the patient with a diagnosis of MWOA headaches.
接触性头痛是由鼻中隔与鼻侧壁接触，通过涉及三叉神经的牵涉痛机制引起的。我们的目标是研究由鼻中隔与筛窦上鼻甲或内侧壁而非中鼻甲接触引起的头痛。
对因头痛接受鼻中隔成形术和鼻窦手术的患者进行回顾性病历审查。选择手术的患者总数为23例。只有12例患者符合鼻中隔与筛窦内侧壁或鼻中隔与上鼻甲之间存在接触点的标准，鼻窦CT扫描证实了这一点。这些患者接受了手术干预以缓解接触点。
根据术前和术后给出的相同疼痛问卷，83%的患者不再抱怨头痛，8%的患者有明显缓解。我们的患者中有41%之前被诊断为偏头痛；其中80%的患者通过手术成功治愈。
接触性头痛和无先兆偏头痛（MWOA）有相似的症状（如畏光、畏声、恶心和呕吐、搏动性质）。我们认为，诊断为MWOA头痛的患者应考虑接触性头痛。
