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Original articles • Braz. j. otorhinolaryngol. 86 (4) • Jul-Aug 2020 • https://doi.org/10.1016/j.bjorl.2019.01.006   copy

Changes in substance P levels of inferior turbinate in patients with mucosal contact headache☆ ☆ Please cite this article as: Eyigör H, Eyigör M, Erol B, Selçuk ÖT, Renda L, Yilmaz MD, et al. Changes in substance P levels of inferior turbinate in patients with mucosal contact headache. Braz J Otorhinolaryngol. 2020;86:450–5. ,☆☆ ☆☆ The manuscript has been presented in ERS 2016. Eyigör H, Eyigör M, Erol B, Selçuk OT, Renda L, Yılmaz MD, et al. Changes in SP levels of inferior concha of patients with mucosal contact headache. ERS. 2016, Stockholm, Sweden, 3–7 July 2016, p22.

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Abstract

Introduction

Mucosal contact headache is a referred pain that arises from contact between the nasal septum and the lateral nasal wall. Evidence supports the role of substance P in a contact headache such that release of substance P from sensory nerve endings causes inflammation and allergy.

Objectives

This study aimed to determine possible differences in substance P levels in inferior turbinate hypertrophy creating a contact headache.

Methods

28 patients who had contact headaches (study group) and 16 volunteers with no complaints were included in the study. Substance P levels in the inferior turbinate tissue samples were quantified using a commercially available substance P EIA kit.

Results

In the study group average substance P levels were 2.65 ± 0.27 pg/mg tissue (range: 0.61–5.44) and in the control group it was 1.77 ± 0.27 pg/mg tissue (range: 0.11–4.35). The difference was statistically significant between the two groups (p = 0.0215). Average preoperative headache group visual analog scale scores was 5.93 ± 0.38 (2–9) and the turbinate volume was 6.56 ± 0.35 cm3 (3.50–10.30). The control group turbinate volume was 4.71 ± 0.39 cm3 (2.50–7.70). We found a correlation between the visual analog scale scores and substance P levels such that substance P levels were higher in visual analog scale scores above 5 (p = 0.001).

Conclusion

This study demonstrates the relationship between intranasal contact headaches and increased mucosal substance P levels. We also found that there is no correlation with substance P levels and volume of the inferior turbinate.

Keywords
Substance P; Inferior turbinate hypertrophy; Contact point headache; Visual analog scale; SNOT-22; EIA

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