Otorhinolaryngology Department, Mansoura University, Mansoura, Egypt.
Eur Arch Otorhinolaryngol. 2011 Sep;268(9):1299-304. doi: 10.1007/s00405-011-1590-2. Epub 2011 Apr 3.
The nasal contact point may act as a trigger point or peripheral enhancer in patients with chronic daily headaches. A total of 42 patients had unsatisfactory response to medical treatment for chronic daily headache with radiologic evidence of nasal contact point. Of them, 12 (28.5%) patients were positive for the local anesthetic test. Those patients were operated upon to separate this contact by either septoplasties or submucous resections with or without partial turbinectomies. The mean headache frequency was reduced from 22 to 7 days/month. The mean headache severity was reduced from 5.6 to 2.4. Eight (19%) patients became completely free from headache and its medications, six (75%) of them were positive for local anesthetic test. The patients were satisfied with postoperative monotherapy, or headache severity and frequency could be tolerated without medications in 26 (62%) patients. There was no improvement in seven (16.6%) patients and only one patient (2%) became worse. The overall satisfaction was 83 and 81% for positive and negative anesthetic tests, respectively. The average monthly medication cost was reduced from $85 to 32. Nasal contact point surgery for chronic daily headache patients can satisfy them compared to previously unsatisfactory medications. Nasal contact point may contribute to potentiating or triggering chronic daily headache.
在患有慢性每日头痛的患者中，鼻接触点可能充当触发点或外周增强剂。共有 42 名患者因医学治疗对慢性每日头痛的反应不佳，且影像学显示存在鼻接触点。其中，12 名（28.5%）患者局部麻醉测试呈阳性。这些患者接受手术分离该接触点，采用鼻中隔成形术或黏膜下切除术，伴或不伴部分鼻甲切除术。头痛发作频率从平均 22 天/月降至 7 天/月。头痛严重程度从 5.6 分降至 2.4 分。8 名（19%）患者完全摆脱了头痛及其药物治疗，其中 6 名（75%）患者局部麻醉测试呈阳性。26 名（62%）患者对术后单一药物治疗满意，或头痛严重程度和频率可以耐受无需药物治疗。7 名（16.6%）患者没有改善，只有 1 名（2%）患者恶化。阳性和阴性麻醉测试的总体满意度分别为 83%和 81%。每月药物费用从 85 美元降至 32 美元。与先前不理想的药物治疗相比，鼻接触点手术可使慢性每日头痛患者满意。鼻接触点可能有助于增强或引发慢性每日头痛。
