Nasal mucosal contact points with facial pain and/or headache: lidocaine can predict the result of localized endoscopic resection

The objective of the study was conducted to evaluate the effectiveness of nasal endoscopy for both diagnosis and localized excision of intranasal contact areas that cause headache and/or facial pain as well as to evaluate the use of lidocaine test for diagnosis of such cases and predicting the result of surgery. This study included 120 patients aged between 18 and 45 years, with an average period of headache and/or facial pain of 2.5 years. Patients were classified into two groups according to lidocaine test. Group A that was lidocaine positive and group B which was negative. Excision of contact points was done, under endoscopic guidance, from the septum as well as the lateral nasal wall. 98.75% of patients in group A got benefit from surgery as most cases were cured from headache and facial pain. In group B, 40% got benefit with most patients had unchanged symptoms. In conclusion, endoscopic surgery gives a more precise complete excision of limited areas without time wasting or morbidity. Lidocaine test can be used as a test to aid in diagnosis and to predict the result of surgery where there were high cure rate within the lidocaine-positive group.