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        New Message Board Archives >> Medications, Treatments, Therapies 2004 >> Fresh Research - Sinus Surgery & CH
        
(Message started by: floridian on Dec 31^st, 2003, 11:26am)

Title: Fresh Research - Sinus Surgery & CH
Post by floridian on Dec 31^st, 2003, 11:26am

Support for those that claim that treating sinus conditions, removing polyps (maybe even the controversial "bone spurs") could help with clusters. This paper argues that there is an interface between the sinuses and the trigeminal nerve that can generate cluster headaches.

Two problem with the study -- 1) cluster headache patients are lumped in with other chronic headache sufferers (at least in the abstract), and the number of patients was small (20). But a 65% response rate sounds promising. I don't know much about endonasal surgery, but I'm guessing that it is less risky than a trigeminal nerve resection. (FWIW, I've got a deviated septum, and who knows what else going on in my sinuses).

Quote:

Laryngoscope. 2003 Dec;113(12):2151-6.

Endonasal surgery for contact point headaches: a 10-year longitudinal study.

Welge-Luessen A, Hauser R, Schmid N, Kappos L, Probst R.

OBJECTIVE: Some migraine and cluster headaches may be triggered by stimulation of intranasal contact points via the trigeminovascular system. Endonasal surgery is successful in some patients, but long-term outcomes have not been reported. STUDY DESIGN: Prospective. METHODS: This investigation included 20 patients with a mean 18-year history of refractory cluster or migraine headaches who were selected for surgery. All had endoscopically visible endonasal contact as well as a positive preoperative cocaine test result. Changes in pain severity and frequency and duration of headache attacks were statistically rated using a MANOVA. Follow-up averaged 112 months. RESULTS: Almost 10 years after surgery, six patients remained completely free of pain, seven had significant symptom improvement, and seven received no benefit from surgery (65% improvement). Two patients had been free of all symptoms for 7 and 8 years, respectively, before complaints returned. CONCLUSION: Our data suggest that some patients with refractory headaches and endonasal contact areas benefit from surgery, thereby supporting the existence of a connection between the two. Even though it is clear that surgery should be considered only if all other treatments have failed, a success rate of 65% over almost 10 years justifies evaluation of this option. Preoperative patient selection remains crucial and warrants further investigation.

Title: Re: Fresh Research - Sinus Surgery & CH
Post by Mark C on Jan 3^rd, 2004, 4:39pm

Interesting......I had sinus surgery in October, in the middle of a cycle ,I know, I'm a dumbass but I did not want CH to rule my life so I had it done out of spite too. I woke up in recovery with a CH that lasted most of the rest of the day, off and on. Never been so sick in my life, the surgery was terrible but I needed it badly. My septum was very deviated and I had harbored a sinus infection for almost two years. If I had not seen my own CT scan, just how bad my sinuses were I would not have had the surgery.

Results after almost three months....I can breath much better and my sense of smell has increased 100 fold....but no effect on my CH. My cycle continued untill Oct 24 when I tried Alternative Therapy (http://www.clusterheadaches.com/cgi-bin/yabb/YaBB.cgi?board=meds;action=display;num=1067037622) with tremendous success. For the first time in 27 years my cycle has been stopped dead in it's tracks and I am still PF today.

Logic seems to dictate some connection between the sinus and CH. I know I produce copious amounts of fluid during an attack from my head so SOMETHING is going on. Hell they treated me for sinus infections for over 15 years before one of them (ENT's) finally sent me to a Neuro who diagnosed me correctly.

Thank God for little fungus!
PFDAN's
Mark

Title: Re: Fresh Research - Sinus Surgery & CH
Post by jflynn on Jan 7^th, 2004, 9:52am

Before I knew I had clusters I went to an ENT and tried all sorts of stuff including prednisone (which didn't work) for what I then thoufght were sinus headaches.

He had me get a CT scan then said I needed sinus surgery to remove a polyp, fix deviated septum and excise some of an oversized turbinate. "You'll be pain-free the very next day." My clusters continued and I was very angry and depressed. He suggested some patients need to have the surgery done a second or third time for relief, an opinion he didn't share previous to the surgery. I fired him.

I then suffered for about 2 more years then found out I had clusters. Melatonin is working well for me so far.

Title: Re: Fresh Research - Sinus Surgery & CH
Post by Gena on Jan 7^th, 2004, 10:09am

I to had surgery. I just happen that I had a two year remission after that. I was so depressed when after 2 years of pain free living the beast came back.
So far two others and I have said that this did not help them is there any positives out there?

Gena