Surgery may be an option in certain cases of sinus headache, such as when you have abnormalities in the nasal passages or growths called polyps that block nasal drainage. It is rarely an option for other types of headache.
If all other measures fail to control cluster headaches, some doctors may suggest cutting or destroying certain nerves in the face. However, the nerve may grow back.
The surgical options for sinus headache include:
Septoplasty is done to correct a deviated septum, which is the wall that separates the left and right nasal cavities. The doctor will remove or reposition portions of the septum that are out of place. The surgery is usually done as an outpatient procedure with either local or general anesthetic.
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FESS opens the natural nasal passages to improve drainage and allow the sinus tissue to return to normal. During this procedure, a thin, fiberoptic tube is inserted into the nose to look at the openings into the sinuses and to remove any tissue blocking the passages. This can often be done as an outpatient procedure. In some cases, this surgery may be done with the help of CT scanning.
There are several surgical procedures which could be done if you fail to respond to all medical treatment. These procedures may include stimulating certain nerves or damaging certain nerves.
In some people, migraines are triggered when a nerve in the head is stimulated. In this surgery, the nerve trigger point is located and deactivated. The surgery may reduce the number of migraines or completely eliminate them in moderate to severe migraine sufferers who do not respond to conventional treatment.
Fact sheet: deviated septum. American Academy of Otolaryngology—Head and Neck Surgery website. Available at: http://www.entnet.org/HealthInformation/deviatedSeptum.cfm. Accessed November 19, 2013.
Kennedy DW, Lanza DC. Current concepts in the surgical management of frontal sinus disease. Otolaryngol Clin North Am. 2001;34(1):1-21.
NINDS headache information page. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/headache/headache.htm. Updated November 8, 2013. Accessed November 19, 2013.
Rozen TD. Interventional treatment for cluster headache: a review of the options. Curr Pain headache Rep. 2002;6:57-64.
Slack R, Bates G. Functional endoscopic sinus surgery. Am Fam Physician. 1998; 58:707-718.
11/10/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: Guyuron B, Reed D, et al. A placebo-controlled surgical trial of the treatment of migraine headaches. Plast Reconstr Surg. 2009;124(2):461-468.
Last reviewed November 2013 by Rimas Lukas, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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