To assess the clinical outcome of endoscopic septoturbinal surgeries in patients with rhinogenic contact point headache. Retrospective audit of medical records. Retrospective audit of medical records of patients having undergone endoscopic surgical management for contact point headache between a period of May 2017 to May 2018 were included in the study. Patients who underwent functional endoscopic sinus surgery were excluded from the study. Pre operative pain score were compared with post operative pain score at interval of 1 month for 3 months consequently and at 1 year interval using Visual Analog scale (VAS). The difference between preoperative (mean 6.82) and post operative VAS pain scores after 1 month (mean 3.36), 2 months (mean 4.50), 3 months (mean 5.48), 1 year (mean 5.01) was statistically significant (p < 0.001). Contact point headache is an important clinical entity that might be missed during evaluation and management of refractory headache. Surgical management under endoscopic guidance can help to ensure removal of mucosal contact point and aid in the treatment of refractory headache as noted in our study.

BACKGROUND: The nasal mucosal contact points between the two opposing mucosal surfaces leading to the headache had been a point of debate for many years; the intermittent and fixed contact points and their relationship with headache have never been investigated before. We have studied the relationship of headache with a different type of contact points in our study.
OBJECTIVE: The aim of our study was to study two different types of mucosal contact point between the lateral nasal wall and the nasal septum and to study their relationship with symptom of headache.There have been many papers published related to the mucosal contact points in the nose and their relationship with headache, most of the published data did not find any relation between the headache and the mucosal contact points. We conducted a retrospective study of 116 patients with deviated nasal septum and contact point with the lateral nasal wall.
METHODS: A retrospective study done at a tertiary institute Included 116 CT scan of paranasal sinuses showing the deviated nasal septum with mucosal contact points, 64 CT scan showed severe deviated nasal septum with fixed contact points between the septum and the inferior turbinate, other 52 scans showed the intermittent mucosal contact point, that is, septum is coming in contact with inferior turbinate only when turbinate is enlarged.
RESULTS: Thirteen patients out of 64 patients (20.31%) had a headache in the fixed contact point group as compared to 20 out of 52 (38.46%) patients in the intermittent mucosal contact points group; post-surgery, the 17/20 patients improved in the intermittent mucosal contact points group as compared to 5/13 in fixed contact points group.
CONCLUSIONS: We conclude that the overall incidence of headache associated with mucosal contact points is low but the higher association is seen in the intermittent contact group.
METHODS: 4.

Headache is a common clinical problem, and appropriate diagnosis and management are a challenge for oral physician. Any minor anatomical variation within the nasal cavity may lead to mucosal contact point, which may be an etiological factor for causing headache and often left behind by clinician during preliminary evaluation of patients with headache or facial pain, resulting in misdiagnosis and inappropriate treatment. This article is an attempt to present a case of rhinogenic contact point headache which may be mistaken for a toothache initially leading to incorrect diagnosis and irrelevant treatment. A thorough, accurate and comprehensive history taking and a complete clinical and general physical examination result in appropriate diagnosis of the clinical situation.