Rhinogenic contact point headache in pediatric age: Our experiences at a tertiary care teaching hospital of eastern India

Abstract

Background: Headache is a common clinical entity seen among pediatric patients in routine clinical practice. The pressure of two opposing mucosa in the nasal cavity even in the absence of inflammation can be a cause of headache, which is called a rhinogenic contact point headache. Anatomical variations of the nose such as rhinogenic contact point headache may result in headache due to the contact of the nasal mucosa which often missed during the evaluation of the pediatric patients. Objective: The aim of this study is to assess the rhinogenic contact point headache in the pediatric age group. Materials and Methods: This is a prospective study and 112 children with rhinogenic contact point headache enrolled in this study. This study conducted at a tertiary care teaching hospital during September 2018–October 2021. The anatomical variations of the nose were evaluated with help of diagnostic nasal endoscopy and computed tomography (CT) scan. These anatomical variations in rhinogenic contact point headache were treated surgically. Results: Out of 112 children with rhinogenic contact point headache, 31 (27.67%) had deviated nasal septum, 28 (25%) had septal spur, 20 (17.85%) middle turbinate concha bullosa, 11 (9.82%) enlarged ethmoidal bullosa, 11 (9.82%) had hypertrophied inferior turbinate, 7 (6.25%) had hypertrophied super turbinate, and 4 (3.57%) had nasal septal bullosa. Treatment of each child with rhinogenic contact point was personalized for every patient. Conclusion: Headache is a common clinical symptom and is nearly universal in the life of a child. The contact between opposing mucosa in the nasal cavity in the absence of inflammation can result in headache and/or facial pain in the pediatric age group. Endoscopic excision of the contact points of nasal cavity is effective for the treatment of rhinogenic contact point headaches.