THE EFFICACY OF SURGICAL INTERVENTION IN ALLEVIATING RHINOGENIC CONTACT POINT HEADACHES: A PROSPECTIVE STUDY ON OUTCOME

Abstract

Introduction: Rhinogenic contact point headache (RCPH) is a frequently overlooked cause of chronic headache and facial pain, resulting from mucosal contact between intranasal anatomical structures. Patients often remain symptomatic despite prolonged medical therapy, making surgical intervention a potential definitive treatment.

Objective: To evaluate the efficacy of endoscopic surgical correction of intranasal contact points in alleviating headache symptoms and improving quality of life in patients with rhinogenic contact point headache.

Methods: This prospective cohort study included 30 patients diagnosed with RCPH who failed adequate medical management and underwent endoscopic nasal surgery over a period of 18 Months. Preoperative evaluation consisted of detailed clinical history, nasal endoscopy, computed tomography of the paranasal sinuses, headache diaries, Visual Analog Scale (VAS) scoring, and Short Form-36 (SF-36) quality-of-life assessment. Surgical procedures included septoplasty, turbinate reduction, concha bullosa correction, and removal of identified mucosal contact points. Patients were followed postoperatively at 1, 3, 6, and 12 months.

Results: The study population had a mean age of 42.15 ± 9.23 years, with female predominance (66.7%). At 12-month follow-up, 90% of patients demonstrated significant symptomatic improvement. Complete headache resolution was observed in 80% of patients, while 10% reported partial improvement. Headache frequency reduced from a mean of 15.6 days/month preoperatively to 3.2 days/month postoperatively, and mean VAS severity scores decreased from 6.8 to 2.5. SF-36 physical component scores improved from 43.2 to 54.5, indicating significant enhancement in quality of life.

Conclusion: Endoscopic surgical management of rhinogenic contact point headache is an effective and safe treatment modality, providing sustained relief from headache symptoms and significant improvement in quality of life in carefully selected patients refractory to medical therapy.