MIDDLE TURBINATE HEADACHE SYNDROME

The middle turbinate and nasal septum are innervated by the anterior e thmoidal nerve, a branch of the ophthalmic division of the trigeminal nerve. As reported in the classical work of Wolff (1948), stimulation of these regions causes pain in the medial canthus of the supraorbital region. Periorbital pain due to middle turbinate compression against the septum or the lateral wall of the nose may be due to congestion of the nasal mucosa or to pneumatization of the middle turbinate (concha bullosa). The diagnosis is made by exclusion and requires a high inde x of suspicion, anterior rhinoscopy, computerized tomography (CT), and confirmation by the lidocaine test. We present five cases of middle t urbinate headache syndrome, all with concha bullosa. Four were treated surgically by partial middle turbinectomy and septoplasty more than 1 year ago, with excellent results. One patient refused surgical treatm ent which was suggested after failure of medical treatment with antihi stamines, decongestants, and a topical corticosteroid, and continues t o be symptomatic. Despite the small number of cases studied, the autho rs conclude that the procedure used was affective for the resolution o f headache.