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Surgical Procedures for Headache

Surgery may be an option in certain cases of sinus headache, such as when you have abnormalities in the nasal passages or polyps (growths) 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 the facial nerve. However, the nerve may grow back.

The surgical options for sinus headache include:

Septoplasty

Septoplasty is performed to correct a deviated septum, the wall separating 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. Nasal packing will be placed during surgery to control bleeding for about 24-36 hours.

Deviated Septum

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Functional Endoscopic Sinus Surgery (FESS)

FESS opens the natural nasal passages to improve drainage and allow the sinus tissue to return to normal. During this procedure, the doctor inserts a thin, fiberoptic tube into the nose to look at the openings into the sinuses and then removes any tissue blocking the passages. This can often be done as an outpatient procedure. In some cases, the doctor may perform this surgery with the help of CT scanning .

Surgical Treatment of Cluster Headache

There are several surgical procedures which could be performed if you fail to respond to all medical treatment. All of these procedures are directed towards the trigeminal nerve or ganglion and may include injecting, cutting nerve, or using radiofrequency thermocoagulation to damage the nerve.

References

Current concepts in the surgical management of frontal sinus disease. Otolaryngologic Clinics of North America . February 2001.

Fact sheet: deviated septum. American Academy of Otolaryngology—Head and Neck Surgery website. Available at: http://www.entnet.org/. Accessed September 12, 2008.

Headache and sinus disease. American Rhinologic Society website. Available at: http://www.american-rhinologic.org/. Accessed September 12, 2008.

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 Sept 1.



Last reviewed July 2008 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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