Welge-Lüssen A, Hauser R, Probst R
HNO-Universitätsklinik, Basel, Schweiz.
Laryngorhinootologie. 1996 Jul;75(7):392-6. doi: 10.1055/s-2007-997602.
Migraine and cluster headache can both be triggered by sensitive intranasal areas.
Endoscopic nasal surgery was performed in 20 patients with chronic migraine without aura or cluster headaches that were refractory to other forms of treatment for a mean period of 18 years (range of 1-45 years). The selected patients showed clinical and radiographic evidence of contact between the middle turbinate and the nasal septum. All patients experienced immediate relief of pain following topical application of cocaine to the presumable triggering area. Five patients with cluster headache and 15 patients with migraine were treated.
All patients with cluster headache were free of symptoms after surgical intervention and for a mean follow-up period of three years. Six of the 15 patients with migraine were completely free of symptoms after a mean follow-up period of three years; five had improved more than 50% in the duration and frequency of their attacks. Treatment was unsuccessful in four patients.
This trial established a likely relationship between nasal trigger areas and cluster headache through the trigeminovascular system and a possible relationship to some type of migraine without aura.
偏头痛和丛集性头痛都可能由敏感的鼻内区域触发。
对20例慢性无先兆偏头痛或丛集性头痛患者进行了内镜鼻窦手术，这些患者对其他形式的治疗无效，平均病程为18年（范围1 - 45年）。所选患者显示出中鼻甲与鼻中隔之间接触的临床和影像学证据。所有患者在向可能的触发区域局部应用可卡因后疼痛立即缓解。治疗了5例丛集性头痛患者和15例偏头痛患者。
所有丛集性头痛患者在手术干预后及平均三年的随访期内均无症状。15例偏头痛患者中有6例在平均三年的随访期后完全无症状；5例患者发作的持续时间和频率改善超过50%。4例患者治疗失败。
本试验通过三叉神经血管系统确定了鼻触发区域与丛集性头痛之间可能的关系，以及与某种无先兆偏头痛之间可能的关系。
