I am at a loss with the pain I have been going through for the past 17 years. Migraines have made me a very mad person and I have had everythin from seeing an allergist to a hysterectomy. Now I have had it with pills that make you sleep and disoriented and I went to an ear, nose, and throat Doctor. She looked at an x-ray that is 8 months old and told me I have a blockage in both nostrils and an S shape which makes it difficult to get a good look around and now we are scheduled for a surgery to be done at the end of this month (Feb.). I am somewhat nervous but always hopeful. Its like the lottery, you can't win if you don't play. She mentioned putting fiber tubes in my nose. What exactly is she talking about. Will they always be ther?
Reply: -------------------------
It is difficult for me to tell exactly what surgery is being proposed based upon what you have posted. As best as I can tell it sounds like your doctor is describing a deformity of the nasal septum and has likely recommended a septoplasty. Please refer to previous posts under the "review" section of the Ears, Nose, and Throat clinic under the topic "deviated septum" for information regarding this procedure. I would caution you however that this procedure is not recommended as a primary treatment for headache. It is intended to alleviate symptomatic nasal airflow obstruction or sinus obstruction. If nasal airway obstruction or symptoms of sinusitis (such as nasal drip, facial congestion or pressure, post-nasal drainage, alteration in sense of taste or smell, etc.) are not significant associated symptoms, then I would be very cautious about pursuing nasal and/or sinus surgery to treat a headache. There is a type of facial discomfort, headache, or pain that is described which occurs with certain anatomic nasal problems and is known as a rhinogenic headache. This is very uncommon, but nasal surgery can be successful in alleviating this type of headache. This type of headache can be diagnosed in most cases by applying a topical anesthetic spray inside the nasal passage during a headache - if the headache is partially or completely relieved, then the headache might be considered rhinogenic.
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Steve Dankle, MD
Otolaryngology-Head and Neck Surgery
Milwaukee, Wis
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