Septoplasty

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  • #46859
    Profile photo of Rachel P
    Rachel P
    Participant

    I recently found that I have a deviated septum that is very likely causing most of my migraines. After visiting and consulting with an ENT, he has suggested a septoplasty and turbinectomy to fix my septum and reduce the size of any overgrown nasal turbines.
    I am seriously considering the surgery and have a lot of information about what the surgery and recovery will entail.
    I wonder if anyone has ever had this surgery or knows anyone who has (whether for migraine relief or just to fix a deviated septum). I’ve read a lot about things, but I know it’s not the same as first person experiential information. I appreciate any and all information that anyone has!

    – Rachel

  • #46887
    Profile photo of Teri Robert
    Teri Robert
    Participant

    Rachel,

    Who told you that the deviated septum is “causing most of your Migraines?” There is no evidence of this in any of the Migraine medical literature.

    I can share my personal experience with you. I had both the septoplasty and trimming of the turbinates some years ago. I’m glad I did because the surgery put a stop to the nearly constant sinus infections I was having. However, it made no difference at all to my Migraines.

    Keep us posted?
    Teri

  • #46899
    Profile photo of Rachel P
    Rachel P
    Participant

    Teri,

    I was told this by my ENT. I am also very prone to sinus infections, so he said that this may help to alleviate them as well.
    I had been looking for literature about this idea of the septum somehow being connected to my migraines, but couldn’t find any. He had me using an anti inflammatory nasal spray when I felt the beginnings of a migraine, and in most cases, it was enough to quell the migraine from fully developing.
    Apparently, the lining in the nasal cavity swells during changes in barometric pressure and hormone level changes, and I am prone to migraines during both of these times. I of course have other triggers, but these were two that I have never had any control of.
    Thank you for sharing your story with me, and I will be sure to keep you posted as this all unfolds!
    -Rachel

  • #46901
    Profile photo of Teri Robert
    Teri Robert
    Participant

    Rachel,

    Thanks for the reply and info. I’ve searched medical literature, and can’t find anything about this type of surgery helping with Migraine.

    Migraine experts don’t know the mechanism by which barometric pressure changes trigger a Migraine. Most of them think it probably has something to do with the impact on cerebrospinal fluid pressure. Certainly, increased CSF pressure can be a Migraine trigger, That’s readily evidenced by the fact that idiopathic intracranial hypertension, a condition in which the CSF pressure is elevated, is a huge trigger for some of us. I’ve never heard the theory about the inflamed nasal cavity before.

    You’re so right that barometric pressure and hormonal changes are very difficult triggers to control. I get a Migraine every time I fly and am likely to get one with weather changes. One thing I have found with the weather changes is that when I have a preventive regimen that’s working well, it helps with Migraines from that trigger too.

    This is an interesting conversation. Will watch for your updates.

    Teri

  • #47639
    Profile photo of nancym
    nancym
    Participant

    Hi Rachel,

    I just now saw your post – sorry I didn’t see it sooner! I also had a septoplasty/turbinectomy surgery to hopefully reduce my headaches. Before going into surgery, my ENT said it wasn’t likely that the surgery would make the headaches stop. He was right about that. However, I was so happy that I did the procedure as I had completely forgotten what it was like to breathe easily through my nose.

    I have headaches pretty much daily and when the weather/barometric pressure changes I am a mess.

    I guess what I am trying to say is don’t get your hopes up for this being a migraine solution, but I highly recommend the surgery in order to get the blockage cleared so you can breathe.

    Good luck and I am interested in hearing what you decide to do.

    Nancy

  • #47712
    Profile photo of Becky
    Becky
    Participant

    I had my deviated septum repaired in 1998, it didn’t help migraines and I never expected it to. But along with taking Mucinex for the rest of my life it has def helped the sinus infections and now I can breath on both sides.

  • #48089
    Profile photo of Brian in TN
    Brian in TN
    Participant

    Hi Rachel,
    Sorry but my septoplasty / turbinectomy in ’97 had basically the same results, much better breathing, especially at night, but no effect on my headaches. I have heard of a new procedure that supposedly shrinks the turbinates permanently without surgery but I don’t know anyone who has had it. I know removing the packing ( tampons) was definitely the worst part of the process so it bears investigation. Of course I was in the Navy when this was performed at a Navy hospital so a civilian procedure could be far less unpleasant. Hope this helps.
    Brian
    P.S. How sure are you those were sinus headaches? I’ve come to the conclusion that most of my “sinus headaches” were actually migraines.

  • #50647
    Profile photo of JLampertMD
    JLampertMD
    Participant

    Headaches are not typically cured with septoplasty, though there has been some significant study in the area – specifically regarding migraines. Dr Guyuron, in Cleveland, has published and presented on the topic extensively. Paranasal headaches, or migraine headaches with a “nasal trigger point” may involve intranasal abnormalities which, in theory, may irritate the end branches of the trigeminal nerve. Surgical treatment of migraines has been proposed by using septoplasty and turbinectomy.

    I still do not feel that septoplasty is widely practiced as a migraine treatment, but it is an interesting subject which requires further exploration. I personally have had patients with forehead trigger points who have improved with botox or dysport treatment to the frontalis muscle. The citations of some interesting article are included below.

    Hope this helps!

    Guyuron B, Reed D, Kriegler JS et al. A placebo-controlled surgical trial of the treatment of migraine headaches. Plast Reconstr Surg 2009; 124(2):461-8.
    Liu MT, Armijo BS, Guyuron B. A comparison of outcome of surgical treatment of migraine headaches using a constellation of symptoms versus botulinum toxin type A to identify the trigger sites. Plast Reconstr Surg 2012; 129(2):413-9.
    Guyuron B, Kriegler JS, Davis J et al. Comprehensive surgical treatment of migraine headaches. Plast Reconstr Surg 2005; 115(1):1-9.
    Guyuron B, Kriegler JS, Davis J et al. Five-year outcome of surgical treatment of migraine headaches. Plast Reconstr Surg 2011; 127(2):603-8.

  • #61554
    Profile photo of Rachel P
    Rachel P
    Participant

    Thanks all for the responses. I still haven’t had the surgery, and have realized that if I do, it would be to ease my sinus infections more than anything else. Thank you all for sharing your stories with me!

    – Rachel

  • #72179
    Profile photo of Kim Hamilton
    Kim Hamilton
    Participant

    I had migraines for 41 years. I just had a successful specialized septoplasty by Dr. Kevin Smith in Houston, Texas. He specializes in migraines; 90% of his patients get migraine relief. He is an ENT and a plastic surgeon. I also had a deviated septum. I had no history of injury but all the classic symptoms of migraines. I usually had 3-4 per week; self injected using triptan type drugs for relief. If your migraines start in your nose, please don’t waste those good years like I did, please get help.

  • #72305
    Profile photo of Katie Golden
    Katie Golden
    Moderator

    Kim,
    Thanks for sharing your story. I would always suggest getting a second opinion for any type of surgery. If it worked for you, I’m so glad it helped! It is often undiagnosed that sinus headaches are actually Migraines. But genuine sinus issues can relieve Migraines. Thanks for sharing!
    -Katie
    Migraine.com Moderator

  • #72476
    Profile photo of Kim Hamilton
    Kim Hamilton
    Participant

    Yes it worked for me. It has been nothing short of miracle since I am absolutely migraine free. We and physicians are taught that migraines have a neurological origin. Dr. Smith is the first doctor I have seen that looked for a physical cause for my migraines. The cure was a day surgery which my insurance covered. See this link to here more of my story on The Doctors TV Show:

    http://www.thedoctorstv.com/episodes/pain-cure-through-your-nose-baby-attached-to-placenta-for-6-days-a-superfood-donut#

  • #80255
    Profile photo of SJD
    SJD
    Participant

    I do believe Kim Hamilton’s story. I saw her on the doctor’s program with Dr. Smith. I’m wondering if other ENT’s can do the same surgery? I can’t go to Houston. I’m also wondering how painful it was when they ripped out the cotton packing with all the dry blood and nose hair stuck to it.

    I’m really concerned that not many ENT’s and other nose surgery experts don’t seem to mention the correlation between migraine and a deviated septum. Why would only Dr. Smith get these results?

    As you can see I’m somewhat cynical and am very afraid of a painful surgery.

    I am not doubting Kim Hamilton’s experience at all. I don’t understand why people would need to travel to Houston when there are lots of board certified ENT and facial plastic surgeons all over the county.

    I appreciate any feed back. I am very glad Kim got her life back!

  • #80327
    Profile photo of Kim Hamilton
    Kim Hamilton
    Participant

    Thank you for your post. I understand your concerns. I had been diagnosed with deviated septum by numerous ENT’s over the 41 years. Yet, all of them told me that they were not causing my migraines. In all of those years I heard about septoplasty from one doctor.

    I had asked my current primary care physician about other alternatives (always looking for something new I had not heard about). She did mention septoplasty but said it was highly controversial. I googled it and then I understood why. Many ENT’s can do sinus surgeries and afterward people have migraines. It’s a scary thought because those who have migraines are very, very protective of those things that could make them worse. If you go to http://www.kevinsmithmd.com he and I did a follow up on the surgery to let people know what to expect and he explains more in detail his procedure. He never packs a nose unless it is necessary; he discusses that. Mine was not packed. I had a little gauze under my nose across my nostrils for about three days. It felt like a bad cold with a lot of drainage. The pain was very manageable. The hardest part is you need to sleep setting up, in my case, for about 10 days. My surgery was February 8, 2016. I have not had a migraine since that day. Also, you don’t have to go to Houston for a diagnoses. Dr. Smith requests you provide him a specific set of CT scans of the sinuses. I believe mine were $400 but insurance paid for all but $200. You send those to him on a CD (no paper reports). He can look at those and he said it is either a yes or no answer. I almost did not get the surgery either. I even told Dr. Smith that he had selected the wrong person for the TV show. Nothing worked for me ever. He assured me that it was going to be much better. It hasn’t been better; it has been absolutely the greatest gift of my lifetime. I welcome you to contact me with any questions you may have no matter how trivial. I did ask Dr. Smith about what is different about his technique. He has perfected it over 20 years. He actually sees a lot of patients that have botched sinus surgeries. Go to his web site if you have a few minutes. Hopefully you will see more answers there. He actually would love to give up facial plastic surgery and just do migraine surgeries. He is really passionate about it.

  • #83699
    Profile photo of stormka
    stormka
    Participant

    Hi Rachel,

    It looks like a lot of folks are trying to talk you out of this! I have a positive comment.

    I recently visited with Dr. Portuese (the best ENT and plastic surgeon I could find) in Washington state about my sinus issues. I have a huge bone spur and allergies that I need tending to. As a side note he said that there was a 60% chance that the procedure to correct the aforementioned would also rectify my migraine issues.

    I would seek a second or third opinion offline. Perhaps someone with good credentials. Not that a forum isn’t a good place to start but I wouldn’t discount some initial good news.

    Good luck!

    -K

  • #88625
    Profile photo of Allison
    Allison
    Participant

    I have a friend whose daughter’s migraines were relieved by Dr. Smith’s surgery so I went for a consult. I did not like his bedside manner and had difficulty getting questions answered during and after my visit. I went back to my ENT at home who evaluated me and performed the exact same surgery Dr. Smith was suggesting. He did not over promise a “cure” as Dr. Smith did as my headaches are multifactorial. I did get quite a bit of relief. Two years later I did have to repeat the sinuplasty because he (and Dr. Smith) did not include addressing the underlying allergies in their treatment plan. My current ENT did that procedure in his office with an easy recovery and I’m on allergy drops and nasal spray to hopefully not have problems again. I had no idea until the CT scans that I get chronic sinus infections and that is ONE thing causing headaches. I would suggest this if you have sinus issues but be realistic.

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