RESEARCH PAPER
Anatomical variations of nose causing rhinogenic contact point headache – a study at a tertiary care hospital of eastern India
Santosh K Swain 1  
,   Alok Das 1,   Mahesh C Sahu 2
 
More details
Hide details
1
Department of Otorhinolaryngology, IMS and SUM Hospital, Siksha ‘O’ Anusandhan University, Odisha, India
2
Directorate of Medical Research, IMS and SUM Hospital, Siksha ‘O’ Anusandhan University, Odisha, India
CORRESPONDING AUTHOR
Santosh K Swain   

Department of Otorhinolaryngology, IMS and SUM Hospital, Kalinga Nagar, Bhubaneswar-751003, Odisha, India. Tel.: +91 9556524887.
Submission date: 2017-02-01
Acceptance date: 2017-08-18
Online publication date: 2018-03-01
Publication date: 2019-11-16
 
Pol. Ann. Med. 2018;25(1):51–55
 
KEYWORDS
ABSTRACT
Introduction:
Headache is a common complaint presented by the patients in daily clinical practice. Anatomical variation of the nose may lead to headache due to contact of nasal mucosa.

Aim:
The aim of this study is to find out the role of different types of anatomical variations of the nose causing contact point headache in a tertiary care hospital.

Material and methods:
108 patients of headache with anatomical variations of nose were studied within period of three years. Careful evaluations of anatomical variations of the nose were done with the help of diagnostic nasal endoscopy and CT scan in chronic headache. These anatomical variations were treated surgically. Data from this group were analyzed.

Results and discussion:
Among 108 patient of rhinogenic contact point headache, nine distinct types of anatomical variations were seen. Different anatomical variations like septal deviation (35.18%), septal spur (26.85%), middle turbinate concha bullosa (23.14%), hypertrophied inferior turbinate (10.85%), medialized middle turbinate (0.92%), large bulla ethmoidalis (1.85%) and septal bullosa (0.92%) were found in patients with contact point headache. All were treated surgically. Treatment of each anatomical contact point was personalized for every patient.

Conclusions:
Headache is a common clinical entity and is nearly universal in the course of everyone’s life. Pressure of two opposing mucosa in the nasal cavity without evidence of inflammation can be a cause of headache or facial pain. There are different anatomical situations leading to rhinogenic contact point headache where each contact point has its own characteristic.

ACKNOWLEDGEMENTS
Authors are thankful to President, Siksha ‘O’ Anusandhan University for extended facility in research.
CONFLICT OF INTEREST
None of the authors has any conflict of interest, financial or otherwise.
 
REFERENCES (14)
1.
Tosun F, Gerek M, Ozkaptan Y. Nasal surgery for contact point headaches. Headache. 2000;40(3):237–240. https://doi.org/10.1046/j.1526....
 
2.
Albirmawy OA, Elsherif HS, Shehata EM, Younes A. Middle Turbinate Evacuation Conchoplasty in Management of Contact-Point Rhinogenic Headache in Children. Int J Clin Pediatr. 2010;1(4–5):115–123.
 
3.
Peric A, Baletic N, Sotirovic J. A case of an uncommon anatomic variation of themiddle turbinate associated with headache. Acta Otorhinolaryngol Ital. 2010;30(3):156–159.
 
4.
Roozbahany NA, Nasri S. Nasal and paranasal sinus anatomical variations in patients with rhinogenic contact point headache. Auris Nasus Larynx. 2013;40(2):177–183. https://doi.org/10.1016/j.anl.....
 
5.
Cady RK, Schreiber CP. Sinus headache: a clinical conundum. Otolaryngol Clin North Am. 2004;37(2):267–288. https://doi.org/10.1016/S0030-....
 
6.
Cady RK, Schreiber CP. Sinus problems as a cause of headache refractoriness and migraine chronification. Curr Pain Headache Rep. 2009;13(4):319–325. https://doi.org/10.1007/s11916....
 
7.
Durham PL. Calcitonin gene-related peptide (CGRP) and migraine. Headache. 2006;46(Suppl 1):S3–8. https://doi.org/10.1111/j.1526....
 
8.
Goadsby PJ, Hoskin KL, Storer RJ, Edvinsson L, Connor HE. Adenosine A1 receptor agonists inhibit trigeminovascular nociceptive transmission. Brain. 2002;125(Pt 6):1392–1401. https://doi.org/10.1093/brain/....
 
9.
Behin F, Lipton RB, Bigal M. Migraine and intranasal contact point headache: is there any connection? Curr Pain Headache Rep. 2006;10(4):312–315. https://doi.org/10.1007/s11916....
 
10.
Anselmo-Lima WT, de Oliveira JA, Speciali JG, et al. Middle turbinate headache syndrome. Headache. 1997;37(2):102–106. https://doi.org/10.1046/j.1526....
 
11.
Peric A, Baletic N, Sotirovicj. A case of an uncommon anatomic variation of themiddle turbinate associated with headache. Acta Otorhinolaryngol Ital. 2010;30(3):156–159.
 
12.
Behin F, Behin B, Bigal ME, Lipton RB. Surgical treatment of patients with refractory migraine headaches and intranasal contact points. Cephalalgia. 2005;25(6):439– 443. https://doi.org/10.1111/j.1468....
 
13.
Behin F, Behin B, Behin D, Baredes S. Surgical management of contact point headaches. Headache. 2005;45(3):204–210. https://doi.org/10.1111/j.1526....
 
14.
Huang HH, Lee TJ, Huang CC, Chang PH, Huang SF. Non-sinusitis relatedrhinogenous headache: a ten-year experience. Am J Otolaryngol. 2008;29(5):326–332. https://doi.org/10.1016/j.amjo....