Effect of Functional Nasal Surgery on Craniofacial Pain: A Prospective Cohort Study

ABSTRACT Objectives Functional nasal surgery reliably alleviates nasal obstruction and improves quality of life. However, functional nasal surgery's effect on craniofacial pain (CFP) has been incompletely studied. This study analyzed CFP outcomes following functional nasal surgery. Methods A prospective cohort study was conducted with patients who underwent functional nasal surgery for nasal obstruction over 18 months by two surgeons. Nasal Obstruction Symptom Evaluation (NOSE, 0–20) and facial pain scores (FPS, 0–5) were collected preoperatively and postoperatively. NOSE and FPS changes were compared between patients with FPS ≥ 2 versus FPS < 2 (i.e., with vs. without preoperative CFP). Results Of 91 patients, mean age was 45.6 years and 62.6% were male. Preoperatively, 36 patients had bothersome CFP, and 12/36 (33.3%) had primary headache disorders. Preoperative mean FPSs were 3.2 and 0.2 for those with versus without preoperative FP, respectively. Mean durations to second and third postoperative visits were 47.7 and 203.1 days, respectively. Across all patients, mean NOSE scores were significantly reduced at each follow‐up (−9.5, p < 0.0001). Patients with preoperative CFP achieved significantly greater reductions in FPSs at second (−1.74 vs. +0.24, p < 0.0001) and third (−2.20 vs. +0.04, p < 0.0001) postoperative visits, and this was not affected by presence of headache disorders or allergic rhinitis ( p > 0.05). The relative risk (RR) of having FPS ≥ 2 was also significantly reduced at second (RR = 0.44, p = 0.0002) and third (RR = 0.33, p = 0.003) postoperative visits. Conclusion In patients with nasal obstruction and CFP preoperatively, functional nasal surgery led to significant improvements in both nasal obstruction and CFP, and these improvements persisted at about 6 months postoperatively. Level of Evidence 2.