Q. What do you think about sinus surgery to stop the source of headaches? I underwent the surgery to stop daily headaches and was headache-free for only about six months.

A. The role of sinus surgery is controversial. Most headache physicians do not believe there is a role for sinus surgery because many of our headache patients have not responded to these surgeries. However, we often do not see the successes of the ear, nose and throat (ENT) physicians because those patients never consult headache physicians. There is evidence in the ENT literature to suggest that a deviated septum that touches the wall of the nose might activate the trigeminal nerve within the sinuses and thus produce headache. Furthermore, they report that surgery reduced the frequency of migraine attacks.

In my experience, some patients will improve only to worsen six or more months later. I wonder if scar tissue develops and entraps the nerves.

Vincent Martin, M.D.
Professor of Medicine
University of Cincinnati
Cincinnati, Ohio