Clinic for Otorhinolaryngology and Maxillofacial Surgery, Clinical Centre of Serbia, Belgrade, Serbia.
Faculty of Medicine, University of Belgrade, Serbia.
Ear Nose Throat J. 2023 Sep;102(9):605-610. doi: 10.1177/01455613211019706. Epub 2021 Jun 2.
The aim of the study is to evaluate the effectiveness of the surgical and nonsurgical treatment of headache caused by contact points (CPs) between the nasal septum and inferior or middle turbinate.
The research was designed as a prospective clinical case-series study. The patients with CP headaches were offered to choose between 2 treatment options, surgery and medical treatment. Two groups of surgically treated patients (surgery groups 1 and 2, depending on whether there is a contact between nasal septum and inferior turbinate or middle turbinate) were evaluated and compared for headache intensity and frequency. Headache intensity was measured using a visual analog scale value from 0 to 10; the frequency of headache was expressed as the number of days during 1 month with a headache (before surgery, 1 month, and 6 months after surgery). A comparison was also made between surgically and nonsurgically treated patients.
We found more intensive and frequent headache in patients who had CP between the nasal septum and the middle turbinate ( = .038 and = .003, respectively). A significant reduction in headache intensity and frequency was found in both groups of surgically treated patients 6 months after surgery; however, this reduction was more significant in patients with mucosal contact between nasal septum and middle turbinate. The nonsurgical treatment made a significant reduction of headache intensity and frequency at 1-month follow-up ( = .012 and = .031, respectively), but not at 6-month follow-up ( = .114 and = .088, respectively).
Surgery gave a statistically significant reduction in the intensity and frequency of headache, which was assessed 6 months after surgery. Surgery was found as superior to nonsurgical treatment in the therapy of CP headache.
本研究旨在评估治疗鼻中隔与下鼻甲或中鼻甲接触点（CPs）引起头痛的手术和非手术治疗效果。
本研究设计为前瞻性临床病例系列研究。为 CP 头痛患者提供两种治疗方案选择，手术和药物治疗。评估并比较两组手术治疗患者（取决于鼻中隔与下鼻甲或中鼻甲之间是否存在接触的手术组 1 和手术组 2）的头痛强度和频率。头痛强度使用 0 到 10 的视觉模拟量表值进行测量；头痛频率表示 1 个月内头痛的天数（手术前、1 个月和手术后 6 个月）。还比较了手术和非手术治疗患者之间的差异。
我们发现鼻中隔与中鼻甲之间存在 CP 的患者头痛更剧烈且更频繁（=.038 和=.003，分别）。两组手术治疗患者在手术后 6 个月时头痛强度和频率均显著降低；然而，鼻中隔与中鼻甲之间存在黏膜接触的患者降低更显著。非手术治疗在 1 个月随访时显著降低了头痛强度和频率（=.012 和=.031，分别），但在 6 个月随访时无显著差异（=.114 和=.088，分别）。
手术在术后 6 个月时可显著降低头痛强度和频率，统计学上有显著差异。手术在 CP 头痛的治疗中优于非手术治疗。
