Frequency of Migraine and Sinus Headaches in Patients Undergoing Primary Rhinoplasty

BACKGROUND: Nearly two-thirds of patients who suffer from migraine headaches (MHs) have a rhinogenic trigger site. Most rhinoplasty patients are female, and an estimated 18% of females suffer from MHs. Rhinogenic MHs and sinus headaches (SHs) are commonly triggered by elements that can be readily addressed during septorhinoplasty. Consequently, this surgery may present a dual opportunity to address MH/SH and cosmetic concerns simultaneously. OBJECTIVES: The aim of this study was to quantify the incidence of MH and SH in patients presenting for primary rhinoplasty. METHODS: A retrospective review was conducted on a consecutive sample of patients who presented for primary rhinoplasty. The senior author's 2-page preoperative questionnaire which inquires about MHs and SHs was used to identify patients who self-reported MHs and SHs. MH and SH incidences were calculated as a percentage of the total number of patient responses. RESULTS: A total of 190 primary rhinoplasty patients (164 females [86.32%] and 26 males [13.68%]) completed preoperative questionnaires and were included in this study. In total, 64 patients (33.68%) had either SHs or MHs: 29 (15.26%) had SHs only, 12 (6.32%) had MHs only, and 23 (12.11%) had both MHs and SHs; 35 (18.42%) had MHs with or without SHs. CONCLUSIONS: MH incidence (18.42%) in this patient sample was greater than the reported global migraine rate of 14% to 15%. By screening for and treating rhinogenic MHs and SHs, surgeons can alleviate symptoms while fulfilling aesthetic objectives. LEVEL OF EVIDENCE: 4 (THERAPEUTIC): For image description, please refer to the figure legend and surrounding text.