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Surgical Procedures for Headache by Debra Wood, RN

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 certain nerves in the face. However, the nerve may grow back.

The surgical options for sinus headache include:

Septoplasty

Septoplasty is done 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.

Deviated Septum

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 done if you fail to respond to all medical treatment. These procedures may include stimulating certain nerves or damaging certain nerves.

Surgical Treatment for Migraine Headache

In some people, migraines are triggered when a nerve in the head is stimulated. In this surgery, the doctor locates the nerve trigger point and deactivates it. The surgery may reduce the number of migraines or completely eliminate them in moderate to severe migraine suffers who do not respond to conventional treatment.

References

Eppley B. Surgical treatment of migraine headaches. Explore Plastic Surgery website. Available at: http://exploreplasticsurgery.com/2009/08/12/surgical-treatment-of-migraine-headaches-sham-vs-actual-surgery/. Published August 12, 2009. Accessed October 8, 2009.
Fact sheet: deviated septum. American Academy of Otolaryngology—Head and Neck Surgery website. Available at: http://www.entnet.org/HealthInformation/deviatedSeptum.cfm. Accessed November 7, 2012.
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 September 2012. Accessed November 7, 2012.
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 2012 by Brian Randall, MD

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