Babak Behin | PubMed Health

PubMed2005

Surgical management of contact point headaches.

INTRODUCTION: Contact point headaches are caused by contact between the nasal septum and the lateral nasal wall by a mechanism of referred pain involving the trigeminal nerve. Our goal was to investigate headaches caused by the contact between the septum and the superior turbinate or medial wall of the ethmoid sinuses and not the middle turbinate. MATERIALS AND METHODS: A retrospective chart review was performed on patients who underwent septoplasty and sinus surgery for headache. The total number of patients who opted for surgery was 23. Only 12 patients met the criteria of having a contact point between the septum and medial wall of the ethmoid sinus, or septum and superior turbinate, which were demonstrated via CT scan of the sinuses. These patients underwent surgical intervention in order to relieve the contact points. RESULTS: According to the same pain questionnaire given pre- and postoperatively, 83% no longer complained of headaches, while 8% had significant relief. Forty-one percent of our patients were previously diagnosed with migraines; 80% of these patients were successfully treated by surgery. DISCUSSIONS: Contact point headaches and migraine without aura (MWOA) have similar symptoms (eg, photophobia, phonophobia, nausea and vomiting, pulsating nature). We believe contact point headaches should be considered in the patient with a diagnosis of MWOA headaches.

Diagnosis, Differential↗

PubMed2005

Cortical adaptation following partial glossectomy with primary closure: implications for reconstruction of the oral tongue.

OBJECTIVES: The considerable variability in functional outcomes for speech and swallowing with different reconstruction techniques following partial glossectomy may reflect the ability of patients to adapt to altered tongue structure. The purpose of this study was to determine mechanisms of cortical adaptation in swallowing to partial glossectomy reconstructed with primary closure. METHODS: Four patients treated with partial glossectomy and primary closure underwent functional magnetic resonance imaging at a mean of 6 months after operation, and the data were compared to those from 8 healthy controls. RESULTS: Statistically significant increases in activity occurred predominately in the parietal cortices and the cerebellum. The volume of the resection was most highly correlated with activity in the premotor and parietal cortices and cerebellum. CONCLUSIONS: The adaptive changes in the cortex following partial glossectomy with primary closure reflect adaptation to the biomechanics of tongue movement during swallowing, and not altered sensation in the tongue.

Adaptation, Physiological↗