الفهرس 
MigraineOnly 14 pages are availabe for public view
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Abstract
In the current study we tried to evaluate the nasal and paranasal findings in cases of migraine and to assess the causal relationship between such findings and migraine. We conducted a cross sectional study to evaluate 60 patients with migraine as diagnosed according to international headache criteria. These patients were compared with 40 subjects having neither migraine nor sinonasal disorders as control group. The subjects of the study were assessed by history taking, endoscopic nasal examination and CT nose and paranasal sinuses. Various septal, turbinate, nasal mucosal or sinus findings were compared between the two groups. In addition, correlation was done between these findings and the severity of migraine.
In the current study, there was a non significant difference between case and control groups regarding age and sex to confirm an age and sex matched control group with case group. The mean age of the group of migraine was 34.67 ± 6.9 SD. The group included 24 (40%) males and 36 (60%) females with a male to female ration 6:9. migraine without aura was the most common type of migraine in the case group and grade 3 severity was the most common grade of severity.
In the current study, case group had more septal, turbinate and mucosal findings than control group with a significant difference ( p = 0.014, p = 0.042, p = 0.039 respectively). There was a statistically significant difference between case and control groups regarding septal spur and a non significant difference between both groups regarding other septal finding including focal deviation, C shaped deviation, S shaped deviation and pneumatized septum. There was a statistically significant difference between case and control groups regarding concha bullosa and a non significant difference between both groups regarding other turbinate findings including hypertrophied inferior turbinate and paradoxical middle turbinate .there was statistically significant difference regarding nasal mucosa with the pale mucosa among case group . septum- middle turbinate contact point was the most common contact point followed by middle turbinate – lateral nasal wall. There was a non significant correlation between the contact point and severity of migraine with more prevalent higher grades (3 and 4) of severity with septum – turbinate contact points and lower grades of severity (1 & 2)with turbinate- lateral nasal wall contact points.
We concluded that migraine headache is a common primary headache disorder that faces the doctor and the patient and causes a lot of challenge to reach a diagnosis and treatment. We found that the presence of nasal findings was significantly associated with triggering of migraine when compared with control subjects. The most common nasal findings in migraine patients in our study were septal spur, concha bullosa and allergic nasal mucosa.
The main mechanism for triggering of migraine by nasal findings is the presence of contact points through the mechanical stimulation of the trigeminal pathway which is considered a common mediation for most types of facial pain and headache. The most common contact point in our study was between the septum and middle turbinate. Higher grades of severity was found with septum – turbinate contact points and lower grades of severity was found with turbinate- lateral nasal wall contact points without reaching statistical significance. On the other hand, allergic rhinitis is an important nasal mucosal pathology which should be respected as a triggering factor for migraine.