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世界核心医学期刊文摘（神经病学分册） 2005年第9期1卷 40-41页

作者： behin F. behin b. b.gal M.E. Lipton R.b. 周永 142 Palisade Avenue Jersey City NJ 07306 United StatesDr.

Contact point headaches have b.en attrib.ted to intranasal contact b.tween opp osing mucosal surfaces, resulting in referred pain in the distrib.tion of the tr igeminal nerve. In sub.ects with primary headaches, contact points may b. associ ated with treatment refractoriness. We aimed to assess the b.nefits of surgical correction in patients with refractory migraine or transformed migraine, and rad iographic evidence of contact points in the sinonasal area. We reviewed charts o f patients who underwent endoscopic sinus surgery and septoplasty for contact po int in the same surgical facility, from Octob.r 1998 through August 2003. Sub.ec ts eligib.e for surgery had: (i) refractory migraine (failed to standard pharmac ological headache treatments) or refractory transformed migraine; (ii) contact p oints demonstrated b. computed tomography scan; (iii) reported significant heada che improvement after topical anaesthesia to the contact area. Headache characte ristics were assessed preoperatively and at follow-up (6-62 months after surge ry) using a standardized questionnaire. A total of 21 sub.ects (72.5%women) wer e assessed. Mean headache frequency was reduced from 17.7 to 7.7 headache days p er month (P=0.003). Mean headache severity was reduced from 7.8 to 3.6 on a 0-1 0 scale (P=0.0001). Headache-related disab.lity was reduced from 5.6 (10-point scale) to 1.8 (P b.ects (76.2%) had their headache scores improved b. 50%or more; nine (42.9%) were pain free at the last follow -up. A total of 18 (95.8%) had at least a 25%reduction in their headache scor es. Two patients (9.5%) had increase in their headache score b. less than 25%. For selected patients with refractory headaches, demonstrab.e contact points, a nd positive response after topical anaesthesia, surgical approach toward the tri ggering factor may b. useful. Prospective studies are necessary to confirm our r esults.

关键词：难治性偏头痛接触点黏膜接触神经分布区内窥镜鼻窦手术鼻中隔成形术放射影像学局部麻醉转换性分量表

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接触点头痛的外科治疗

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世界核心医学期刊文摘（神经病学分册） 2005年第8期1卷 36-36页

作者： behin F. behin b. behin D. b.redes S. 袁海峰 Division of Otolaryngology Christ Hospital 142 PalisadeAvenue Jersey City NJ 07306 United States Dr.

*** point headaches are caused b. contact b.tween the nasal s eptum and the lateral nasal wall b. a mechanism of referred pain involving the t rigeminal nerve. Our goal was to investigate headaches caused b. the contact b.t ween the septum and the superior turb.nate or medial wall of the ethmoid sinuses and not the middle turb.nate. Materials and Methods.A retrospective chart revie w was performed on patients who underwent septoplasty and sinus surgery for head ache. The total numb.r of patients who opted for surgery was 23. Only 12 patient s met the criteria of having a contact point b.tween the septum and medial wall of the ethmoid sinus, or septumand superior turb.nate, which were demonstrated v ia CT scan of the sinuses. These patients underwent surgical intervention in ord er to relieve the contact points. *** to the same pain questionnai re given pre-and postoperatively, 83%no longer complained of headaches, while 8%had significant relief. Forty-one percent of our patients were previously di agnosed with migraines; 80%of these patients were successfully treated b. surge ry. *** point headaches and migraine without aura (MWOA) have si milar symptoms (eg,photophob.a, phonophob.a, nausea and vomiting, pulsating natu re).We b.lieve contact point headaches should b. considered in the patient with a diagnosis of MWOA headaches.

关键词：接触点上鼻甲鼻腔外侧壁筛窦中鼻甲患者病例鼻窦手术内侧壁牵涉痛图表分析

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