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Surgical treatment of Rhinogenic Migraines: A Meta-Analysis of Patient-Reported Outcome Measures
Viren Patel, Quan Lu, Berk Ozman, R�ay Fodor, Ali Totonchi
Cleveland Clinic
2025-01-08
Presenter: Viren Patel
Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting. The program director is responsible for making a statement within the confines of the box below specific to how much of the work on this project represents the original work of the resident. All authors/submitters of each abstract should discuss this with their respective program director for accurate submission of information as well as the program director's approval for inclusion of his/her electronic signature.
Director Name: Raymond Isakov
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Background:
Anatomic aberrancies of the nasal passages have been implicated in the pathophysiology of headaches. Surgical approaches have been developed to address rhinogenic migraines, due to nasal contact points, but diagnosis, treatment and success of surgery remains poorly understood due to heterogeneity of literature.
Methods:
A systematic review was performed to identify studies that included patient-reported outcome measures (PROMs) following surgical treatment of rhinogenic migraines, usually with septoplasty or turbinate reduction.
Results:
14 studies met inclusion criteria comprising 591 patients. There were diverse terms to describe the condition including, �contact point headache� (n=6, 42%), �rhinogenic headache� (n=4, 29%), and �Rhinogenic contact point migraine� (n=2, 14%). The pooled mean difference in visual analog scale (VAS) score after surgery was 3.85 (95% CI: 3.80-3.90, p < 0.001). When comparing surgical and medical management, surgical patients had significantly greater improvement of VAS scores and significantly fewer headache days per month (p<0.05). VAS score improvement was similar for different indications including turbinate contact, septal spur and concha bullosa.
Conclusion:
We present the first meta-analysis of studies describing surgical treatment of rhinogenic migraines. There is a large heterogeneity of terminology used to describe this condition and suggests that the migraine community should strive to used standard terminology and diagnostic standards. Overall, analysis confirms significantly improved results for surgical management over medical treatment. Additionally, it seems that patients benefit from similar reduction in migraine symptoms, regardless of indication or severity of symptoms. Future studies should aim to better characterize patient complaints and predict which patients would benefit most from surgery.
