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Functional Endoscopic Sinus Surgery Is Effective In The Relief Of Migraine Headaches
Mengyuan T. Liu, BS, Harvey Chim, MD, Bahman Guyuron, MD, FACS, David W. Stepnick, MD, FACS.
Case Western Reserve University School of Medicine and University Hospitals Department of Plastic Surgery, Cleveland, OH, USA.

PURPOSE: Irritation of sensory nerve endings through obstruction of secretion flow and chronic sinusitis may contribute to the pathogenesis of retro-orbital migraine headaches. Abnormalities in the sinuses were diagnosed following CT imaging and were treated through functional endoscopic sinus surgery. The purpose of this study was to determine if sinus surgery resulted in relief of migraine headaches.
METHODS: The medical charts of 44 patients who underwent endoscopic sinus surgery for the purpose of migraine headache relief were reviewed. The preoperative and >12-month postoperative retro-orbital migraine frequency, duration, and intensity were analyzed to determine the success of the surgeries.
RESULTS: Following endoscopic sinus surgery, 33 (75.0%) of the 44 patients experienced a successful reduction in retro-orbital migraine headaches (at least 50% decrease in migraine frequency, duration, or intensity), with 9 (20.5%) experiencing complete elimination. The mean postoperative pain frequency and severity were significantly reduced (p < 0.0001) after surgery. The most common sinus surgery was ethmoidectomy (38 of 44 patients), followed by maxillary antrostomy (35 of 44 patients). Eleven (25%) of the 44 patients underwent secondary sinus surgery to further reduce migraine headaches.
CONCLUSION: The results of this study provide evidence that sinus pathology is a significant contributor to migraine headaches and that functional endoscopic sinus surgery is effective at relieving retro-orbital migraine headaches.


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