Changes in substance P levels of inferior turbinate in patients with mucosal contact headache

Abstract

IntroductionMucosal contact headache is a referred pain that arises from contact between the nasal septum and the lateral nasal wall. Evidence supports the role of substance P in a contact headache such that release of substance P from sensory nerve endings causes inflammation and allergy. ObjectivesThis study aimed to determine possible differences in substance P levels in inferior turbinate hypertrophy creating a contact headache. Methods28 patients who had contact headaches (study group) and 16 volunteers with no complaints were included in the study. Substance P levels in the inferior turbinate tissue samples were quantified using a commercially available substance P EIA kit. ResultsIn the study group average substance P levels were 2.65±0.27pg/mg tissue (range: 0.61–5.44) and in the control group it was 1.77±0.27pg/mg tissue (range: 0.11–4.35). The difference was statistically significant between the two groups (p=0.0215). Average preoperative headache group visual analog scale scores was 5.93±0.38 (2–9) and the turbinate volume was 6.56±0.35cm3 (3.50–10.30). The control group turbinate volume was 4.71±0.39cm3 (2.50–7.70). We found a correlation between the visual analog scale scores and substance P levels such that substance P levels were higher in visual analog scale scores above 5 (p=0.001). ConclusionThis study demonstrates the relationship between intranasal contact headaches and increased mucosal substance P levels. We also found that there is no correlation with substance P levels and volume of the inferior turbinate.