Prevalence of Mucosal Contact and Correlation with Migraine: The Predominance of the Superior Turbinate.

Abstract

Background: Mucosal contact between the turbinates and septum is implicated as a cause of headache and migraine. The prevalence of mucosal contact is reported to be as low as 4%. However, the inclusion criteria in that study were restrictive, and no data on the superior turbinate were reported. We sought to determine the prevalence of mucosal contact on nasal endoscopy and its association with migraine. Methods: A cohort study of 355 subjects was conducted. All patients underwent nasal endoscopy and were queried as to migraine history. The prevalence of mucosal contact in the migraine cohort was compared to that in the non-migraine cohort, and the prevalence of migraine in the contact cohort was compared to that in the non-contact group. The frequency of mucosal contact at each turbinate involved was noted. Results: The overall prevalence of mucosal contact was 49.3% (175/355). The superior turbinate was most frequently involved (34.9%: 124/355), followed by the inferior turbinate (14.6%; 52/355), the middle turbinate (14.1%: 50/355), and multiple turbinate involvement (13.5%; 48/355). Migraine history was elicited in 31.8% of subjects (113/355); 52% (91/175) of patients with mucosal contact reported migraine history; 65.3% (81/124) with superior turbinate contact, 50% (25/50) with middle turbinate contact, and 21.1% (12/52) with inferior turbinate contact; 80.5% (91/113) of patients with migraine demonstrated mucosal contact; 71.7% (81/113) with superior turbinate contact, 22.1% (25/113) with middle turbinate contact, and 10.6% (12/113) with inferior turbinate contact. Multivariate analysis demonstrated that superior and middle turbinate contact were associated with migraine (P < .001 and P = .034, respectively), but inferior turbinate contact was not (P = .272). Conclusion: Mucosal contact is much more prevalent than previously reported and is associated with migraine, especially at the superior turbinate level.