Mucosal contact point headache – a true clinical entity?
DOI:
https://doi.org/10.34631/sporl.3126Keywords:
rhinogenic headache, mucosal contact point, controversyAbstract
Introduction: Rhinogenic headache, as classified by the International Classification of Headache Disorders (ICHD), encompasses headaches originating from sinonasal pathology. One of the most debated etiologies is mucosal contact point headache, a controversial entity that was removed from the ICHD-3 in 2018.
Objectives: To determine whether mucosal contact points represent a true clinical entity and whether their surgical correction is effective in resolving headache symptoms.
Materials and Methods: Systematic review according to PRISMA standards. Searches were conducted on the PubMed platform using "rhinogenic headache" and "contact point headache" in English and Portuguese, with no date restrictions. Studies evaluating the prevalence of mucosal contact points and their association with headache, as well as studies reporting clinical outcomes of patients undergoing surgical treatment, were included.
Results: Of the 220 articles initially identified, 80 were potentially eligible for both objectives of this review, and 33 met inclusion criteria. Most studies reported significant pain improvement, with a reduction in Visual Analog Scale (VAS). However, they have several limitations, such as small sample sizes (≤50 patients) and short follow-up (<24 months).
Conclusions: Mucosal contact points should be considered a potential etiology in cases of refractory headache. Some patients may benefit from surgical correction to eliminate mucosal contact; however, it is important to manage patient expectations, as current evidence is limited by methodological bias and study heterogeneity. Randomized clinical trials with larger sample sizes and longer follow-up are needed.
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