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Nasal Pathology in the Migraine Surgery Population: Incidence, Patterns and Predictors of Surgical Success
Michelle Lee MD, Cameron Erickson BS, Bahman Guyuron MD
University Hospitals Case Medical Center, Case Western Reserve University
2015-02-25
Presenter: Michelle Lee, MD
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. This submission represents the original work of the resident and the authors.
Director Name: Hooman Soltanian
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Aesthetics
PURPOSE: Identify patterns of nasal pathology in 100 migraine surgery III (septonasal) patients.
METHODS: A retrospective review was performed on 100 migraine III patients. Demographics, pre/post migraine surgery symptoms, and pathology seen on preoperative computed tomography (CT) scans were reviewed.
RESULTS: Twenty percent of patients had preoperative sinus disease. The following pathologies were seen on CT scan: septal deviation (77%), septal spur (33%), concha bullosa (48%), sinus pathology (20%), and intranasal contact points (62%). Compared to CT scans of the general population, this population had a higher incidence of septal deviation (77% migraine vs 27% general), and concha bullosa (48% migraine vs 25% general). A higher incidence of clinical sinusitis (20% migraine vs. 5-15% general) was also seen. Septoplasty was performed in 87%, and conservative turbinectomy in 60% of patients. Patient who failed surgery (<50% reduction in migraine index) had a significantly higher incidence of contact points (80.7% vs. 55.4%, p=0.016) than successful migraine patients.
CONCLUSIONS: The migraine III population has an increased incidence of septal deviation, sinus disease and turbinate abnormality. It is likely that the failure to achieve more successful outcome was the consequence of conservative nasal management and residual contact points due to concern for the development of nasal dryness.
