Impact of middle turbinate conchoplasty in management of rhinogenic contact headache

Abstract

Background Rhinogenic contact point headache (RCPH) is intermittent pain localized in the periorbital and temporozygomatic or medial canthal regions. RCPH occurs owing to the presence of anatomical variations between adjacent mucosal surfaces in the nasal cavity. Concha bullosa (CB) is pneumatization of the middle turbinate, which is a common anatomic variation of lateral nasal wall. CB may increase in such a way that it fills the space between septum and lateral nasal walls, which creates areas of mucosal contact, predisposing to rhinogenic headache. Aim To evaluate the efficacy and outcomes of endoscopic turbinoplasty technique for CB ‘conchoplasty’ compared with lateral partial turbinectomy (LPT), in patients with RCPHs not responding to medical treatment. Patients and methods A prospective study was conducted that included 30 patients with RCPH and significant CB. The patients were randomly divided into two groups: group A included 15 patients who underwent LPT and group B included 15 patients who underwent conchoplasty. Results Complete cure or significant reduction in the severity of complaints reported in 13 patients who underwent LPT. In the conchoplasty group, 14 patients were completely cured at the end of the follow-up period. In the LPT group, a complication noted was synechiae formation in two cases. Conclusion Compared with LPT, conchoplasty is an equally effective surgical treatment of significant CB with lesser incidence of complication.