Effect of Endoscopic Lateral Lamellectomy in Concha Bullosa Induced Rhinogenic Headache

Abstract

Purpose: To assess the effect of surgical intervention (endoscopic lateral lamellectomy) in relieving the contact point headache induced by Concha bullosa. Patients and Methods: 20 patients with persistant headache for one year or more presented in the period from June 2018 to February 2020. Surgical intervention was done according to C.T nose and paranasal sinuses in each case , bilateral endoscopic lateral lamellectomy was done in 35%, unilateral endoscopic lateral lamellectomy in 65%. Results: In the current study, and according to MIDAS score of headache there was 10% of patient with mild disability (MIDAS Grade II), 50% with moderate disability (MIDAS Grade III) and 40% with sever disability (MIDAS Grade IV) preoperatively, MIDAS score ranged from 8-39 with mean score of 20.3 ± 8.89. 3 months postoperatively all the patients were with little or no disability (MIDAS Grade I), MIDAS score ranged from 0-4 with mean score of 1.7 ± 1.21, the p value is <0.001. Conclusion: Concha bullosa is considered one of the most important factors in the development of contact point rhinogenic headache and this headache can be cured or significantly improved after endoscopic lateral lamellectomy with no or minimal complications providing that accurate selection of the patients and skilled surgeon.