Headache Treatment

Researches » Headache Treatment

 

 

MIDDLE TURBINATE LATERALIZATION:

A SIMPLE TREATMENT FOR RHINOLOGIC HEADACHE

 

 

Headache is a very common complaint among everyone. Most commonly, the cause that we point to is just plain migraine, with a number of probable root cause, one of which is rhinologic cephalgia induced by contact point between the middle turbinate and the nasal septum. Traditionally, this condition is corrected by a combination of middle turbinectomy and septoplasty, a somewhat invasive approach for a comparative simple condition.

As a seasoned otolaryngologist, Prof. Kunachak devised a technique involving the fracturing of the middle turbinate lateralward to break the contact point between the middle turbinate and the nasal septum.

For this study, Prof. Kunachak treated a total of 55 patients (all with full consent for the procedure) with chronic nasal and glabellar pain and endoscopically proven nasal origin. Patients were also chosen according to the following criteria:

1.     Absence of infectious rhinosinusitis

2.     Absence of nasal neoplasm

3.     Absence of typical history of neurovascular headache

4.     No history of facial trauma

5.     Endoscopically confirmed contact point between the nasal septum and the middle turbinate

6.     Immediate relief of the presenting pain after application of topical 10% lidocaine HCL at the contact point

Besides a complete physical examination, all the patient were subjected to telescopic examination to rule out any mucosal disease or neoplasm and to demonstrate the presence of a contact point between the middle turbinate and the nasal septum. Plain paranasal sinuses radiography was also done to confirm the absence of sinusitis.

The procedure was done under local anesthesia. No incision is involved in the procedure, only an endoscope for viewing and a narrow blade, metal tongue depressor inserted between the middle turbinate and the nasal septum. A crackling sound was sometimes heard by both patient and the surgeon (Prof. Kunachak). Patients are ablre to return to work immediately after the procedure.

Follow ups were scheduled every 2 weeks post treatment, while plain paranasal sinus radiography was done after 1 month. Success of the procedure was determined by patients reporting relief from symptoms.

Of the 55 subjects that were treated, 87% had complete resolution of symptoms after only one treatment while the remaining 13% had partial resolution. These remaining 13% or 7 patients reported completely relief the 2nd treatment.

Follow ups were done for an average of 50 months to make sure recurrence will be noted.

 

In conclusion, Prof. Kunachak noted that Middle Turbinate Lateralization is an effective method to relieve headache caused by rhinologic cephalgia induced by contact point between the middle turbinate and the nasal septum.

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  • Headache Treatment
    Researches » Headache Treatment

    As Professor Somyos Kunachak, the founder of Yoskarn Clinic, believes that medicine, in this case, cosmetics, plastics, dermatology, and anti-aging, should continuously find ways to provide solution to on going patient dilemmas, several of his researches has been published and are now being used by other doctors in their clinical practices.  

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