🧠 Overview
Nasoseptal migraines originate from compression of nerves inside the nasal cavity, particularly where the nasal septum makes contact with the lateral nasal wall (contact points). These headaches are often mistaken for sinus headaches.
🎯 Affected Nerve:
Nasoseptal Nerve (Branch of Anterior Ethmoidal Nerve)
Releasing the nerves inside the nose
💭 Headache Characteristics
📍 Pain Location
Pain is felt deep behind the eyes, at the bridge of the nose, or deep within the nasal cavity. Patients often point to the area between their eyes.
⚡ Pain Character
Deep, aching pressure that feels like intense sinus pressure. Often described as feeling like "something is pressing from inside the nose" or "pressure building behind the eyes."
🌊 Pain Migration Pattern
The pain typically stays focused in the midface region, behind and between the eyes, across the nasal bridge. It may radiate to the forehead but remains predominantly central.
✨ Pain Quality
Constant deep pressure rather than throbbing. The pain is often worse with weather changes, bending forward, or lying down. Patients may experience associated nasal congestion or facial fullness.
🔬 How we confirm it: the numbing test
This test needs no needle at all. We place a small cotton pledget soaked in numbing medicine against the contact point inside your nose. If your pain lifts within 10-15 minutes, we have found your trigger. We usually also look at a CT scan of the sinuses to see the contact point clearly.
💡 Important: We never recommend surgery without this test, your trust matters too much. If the numbing injection relieves your pain, surgery is very likely to help you. If it does not, we will tell you honestly and keep looking for answers with you.
⚕️ What the operation involves
This operation is done entirely through the nostrils with a thin camera, there is no cut on the skin at all and no visible scar. Dr. Sarhane removes the small spur of bone or the bend in the septum that is pressing on the nerve. It takes 30-45 minutes, under general anaesthesia or sedation as you prefer, and you go home the same day. Nothing goes inside the skull.
📊 What you can realistically expect
💊 Pain relief
Around 80-85% of patients with a confirmed contact point improve significantly. Many also find that the "sinus infections" they kept being treated for simply stop.
💊 Fewer medicines
Approximately 70% of patients reduce their medication use by at least 50%. Many no longer mistake their headaches for sinus infections and stop unnecessary antibiotic use.
🏥 Getting back to your life
Any nasal packing comes out within 24-48 hours. Expect a blocked, stuffy nose and mild discomfort for 1-2 weeks, like a heavy cold. The inside of the nose heals fully in 4-6 weeks. There is no bruising and no visible scar.
⏱️ What the first weeks usually look like:
- First few days: rest at home, simple painkillers if needed. Most people describe soreness rather than pain.
- First week: light activities and desk work for most trigger zones.
- Weeks 2-4: gradually back to exercise and your normal routine.
- Months 1-6: the nerve settles and your migraines improve step by step. Our nursing team stays in touch with you throughout, you are never on your own.