內視鏡手術治療中鼻甲頭痛症候群

Endoscopic Surgery in the Treatment of Middle Turbinate Headache Syndrome

韓鎮安(Chen-An Han) ； 莫振東(Chen-Dong Mor) ； 袁本治(Ben-Chih Yuan)

《中華民國耳鼻喉科醫學會雜誌》 31卷5期 (1996/10) Pp. 363-367

https://doi.org/10.6286/1996.31.5.363

摘要

中鼻甲頭痛症候群為鼻源性頭痛的一種，大多由於中鼻甲形狀扭曲、粘膜增生或泡狀鼻甲不正常接觸鼻中隔或鼻腔側壁，而刺激支配中鼻甲前端感覺的三叉神經眼枝引起的牽涉性頭痛。本篇收集10例接受手術治療的中鼻頭痛症候群患者，探討其病理生理機轉，臨床表徵，治療方式與結果。藉此提醒臨床醫師對一反覆性未明原因之頭痛，耳鼻喉科醫師或可提供正確診斷與治療。

關鍵字

中鼻甲頭痛症候群 ； 泡狀鼻甲

並列摘要

Middle turbinate headache syndrome is theorized that an enlarged middle turbinate, most commonly due to pneumatization (concha bullosa), may contact the septum or lateral nasal wall and cause headaches referred from the ophthalmic division of the trigeminal nerve, the main sensory innervation of the anterior end of the middle turbinate. Middle turbinate headache syndrome is reviewed, with attention to pathophysiology, clinical presentation, and treatment. Ten cases of middle turbinate headache syndrome undergoing surgery were presented in support of this this clinical entity. Medical therapy was attempted initially in all patients, including oral decongestants, nonsteroid antiinflammatory drugs, antihistamines and topical steroid sprays. Antibiotics were prescribed in the case of concha bullosa with adscess formation. Due to no noted improvement of headache, the ten patients were suggested to undergo surgery. In the eight cases of concha bullosa, the operative procedure performed was partial resection of the lateral aspect of the middle turbinate, the medial aspect was retained and positioned so as not to contact the septum or lateral nasal wall. In the other two cases of distorted middle turbinate combined with nasal septal deviation, septoplasty and partial resection of the middle turbinate were performed. All patients undergoing surgery had complete relief of headache by 1 month postoperatively, except two patients (the case of concha bullosa wih abscess and the other case of distorted middle turbinate combined with septal deviation) who still has occasional headache, but the heasdaches occur significantly less frequently than prior to surgery. We hope to alert the clinician to a relatively unknown source of recurrent headaches that may be readily treated by otolaryngologist.

並列關鍵字

middle turbinate headache syndrome ； concha bullosa