WILL A RHINOPLASTY ALLEVIATE BREATHING PROBLEMS AND POSSIBLY MIGRAINES?

Question:
I’ve wanted to have my nose done for a long time,not just because of how it looks. I believe that the inner workings of my nose are behind my issues – constant, painful headaches/migraine. I’d rate them 9-10/10 on the pain scale, usually in the front of my head, around the sinuses -Mouthbreathing! My dentist/hygienist always say my mouthbreathing causes shifting of teeth/dry gums,which have caused many problems I smashed my nose pretty good a few times when I was younger, and not sure if I broke it.

Dr. A’s Answer:

Rhinoplasty and Migraines:

The septum (which is the partition starting at the nostrils and going all the way to the throat) can have a spur (a spiked out section) that is so large that it completely crosses the air passage part of your nose, embedding itself into the sidewall. The result of this may be severe and persistent headaches. This is far from being the most common cause of headaches, however, it is common enough to consider. This type of headache may get worse with conditions that cause swelling in your nose like colds and allergies. A proper exam of your nose in the office can rule it out immediately if no spur is present. If a spur is present and pressing against the sidewall, the possibility exists that it is the source of your headaches. If numbing the inside of your nose alleviates the headache, it is highly likely that it is the cause. However, if the headache doesn’t go away with numbing, that doesn’t rule-out the spur as the culprit. Surgical removal of the spur would be the only true way to rule it out as the cause. The headache would be immediately “cured” by surgical removal of the spur if indeed it were the culprit. I have “cured” about a dozen patients of these headaches in my career. Curiously, several of those patients never reported the headache issue prior to surgery, had no expectation of the surgery fixing the headaches, and were surprised afterward when they no longer had headaches.

A septoplasty would potentially improve the airway if an obstructive deviation or spur were present. Not all spurs and deviations result in airway obstruction. A turbinate reduction is also a very good way to improve the airway and often times is more important than the septoplasty. Turbinates are outcroppings from the sidewall of the inside of your nose and have a large capacity to swell and shrink. They are the primary cause of obstruction that comes and goes with such things as colds, allergies, and position (laying down vs being upright, even laying on the left vs right). A turbinate reduction will not stop them from fluctuating, but at any given degree of swelling, they will be smaller than they would otherwise have been.

Rhinoplasty is a surgery that alters the appearance of your nose. Typically a rhinoplasty alone would have no affect on your breathing. I say “typically” because there are situations where it could improve or worsen the airway.

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