Posterior Nasal Nerve Ablation for Treatment of Chronic Migraine
Marc G. Dubin, R. Peter Manes, Ellen M. O’Malley, David M. YenBackground
The posterior-lateral nasal cavity has been used as a target for locoregional anesthetic block for primary headache. Anecdotal observations of improved migraine frequency and severity in patients treated with radiofrequency ablation for rhinitis have suggested the potential of this treatment for chronic migraine.
Objective
To explore the impact of impedance-controlled posterior nasal nerve radiofrequency ablation on headache frequency, symptoms, and quality of life in adults with chronic migraine.
Methods
This is a prospective, single-arm, multicenter, feasibility clinical study of bilateral impedance-controlled posterior nasal nerve radiofrequency ablation in adults with chronic migraine with or without chronic rhinitis symptoms. Participants completed follow-up visits at 2, 4, and 6 months after the procedure. Daily headache logs were completed. Outcome measures included mean monthly migraine headache days (MMHD), 50% responder rate (MMHD-50), mean monthly headache days, Headache Impact Test (HIT-6), Migraine-specific Quality of Life Questionnaire (MSQ), and Sinonasal Outcome Test (SNOT-22).
Results
Six investigational centers enrolled 24 participants with 21 participants completing the 6-month follow-up. The MMHD change from baseline was –5.2, –6.1, –7.1, –7.3, –7.5, and –6.0 at 1, 2, 3, 4, 5, and 6 months, respectively (all
Conclusions
A single bilateral treatment of impedance-controlled radiofrequency ablation of the posterior nasal nerves was associated with significant improvement in migraine frequency, quality of life, and migraine-related burden through 6 months after the procedure in adults with chronic migraine.