Rhinogenic Migraine Surgery in Phoenix, AZ
Relief is provided by either releasing muscle fibers or freeing nerves through decompression surgery. The specific nature of the surgery depends on the trigger site. Rhinogenic patients whose headaches are triggered intra-nasally may have a deviated septum or enlarged turbinates coming into contact with the septum. Prior to surgery, each patient will undergo a computed tomography (CT) scan to help identify such abnormalities.
Understanding Rhinogenic Contact Point Headache
Rhinogenic contact point headache refers to headache pain that may be associated with areas inside the nose where opposing nasal structures come into contact. These contact points can involve the nasal septum and turbinates and may be associated with anatomical differences such as a deviated septum, septal spur, enlarged turbinate, or concha bullosa.
Rhinogenic headache is not the same as a sinus infection, and not every headache involving pressure around the nose, forehead, or eyes originates from the nasal cavity. Migraine and other headache disorders can produce similar symptoms. For this reason, identifying a nasal contact point alone does not confirm that it is responsible for a patient’s headaches.
Careful evaluation is important to determine whether a patient’s headache pattern and nasal anatomy suggest that an intranasal trigger may be contributing to their symptoms.
How Is a Rhinogenic Headache Trigger Evaluated?
Evaluating a possible rhinogenic headache trigger involves more than identifying an abnormality inside the nose. The goal is to determine whether the patient’s symptoms and nasal anatomy reasonably correspond with one another.
The evaluation may include:
- Headache history: Reviewing where the pain begins, how often it occurs, and whether it follows a consistent pattern.
- Nasal examination: Looking for areas where the nasal septum, turbinates, or surrounding tissues may be coming into contact.
- CT imaging: Imaging may help identify structural findings such as a deviated septum, septal spur, enlarged turbinate, or concha bullosa.
- Targeted diagnostic testing: In selected patients, temporary relief after local anesthetic is applied near a suspected contact point may provide additional information.
- Evaluation of other causes: Migraine, sinus disease, neurological conditions, and other headache disorders may produce similar symptoms and should be considered.
Imaging findings alone do not determine whether surgery is appropriate. Dr. Jason Johnson considers the patient’s headache pattern, examination findings, medical history, and nasal anatomy when determining whether a rhinogenic trigger may be contributing to their symptoms.
How Is Rhinogenic Migraine Surgery Performed?
When an intranasal contact point is determined to be a likely contributor to a patient’s headaches, surgery is designed to reduce or eliminate contact between the involved nasal structures.
The exact procedure depends on the patient’s anatomy. Treatment may involve correcting part of a deviated nasal septum, addressing a septal spur, reducing an enlarged turbinate, or treating another structural area responsible for contact within the nasal cavity.
The objective is not simply to create more space inside the nose. The surgical plan is individualized to address the specific anatomical area believed to be contributing to the patient’s headache trigger.
Rhinogenic headache surgery is intended for carefully selected patients and is not a first-line treatment for migraine or unexplained headaches. Because similar symptoms can result from migraine, sinus disease, and other headache conditions, appropriate evaluation and identification of the suspected trigger are essential before considering surgery.
Healing and Recovery
Swelling and bruising are common following the procedure. This generally lasts about a week to 10 days. Strenuous activity should be avoided for 3 weeks. Patients who experience improvement may find that their need for headache medication changes over time. Medication adjustments should be discussed with the prescribing physician.