CT Imaging Biomarkers in Rhinogenic Contact Point Headache: Quantitative Phenotyping and Diagnostic Correlations

Area of Science:

• Otorhinolaryngology
• Radiology
• Neurology

Background:

• Rhinogenic Contact Point Headache (RCPH) diagnosis is challenging due to varied anatomy and imaging standards.
• A standardized CT-based approach is needed for accurate RCPH assessment.

Purpose of the Study:

• To develop and validate a CT imaging framework for diagnosing RCPH.
• To identify radiological biomarkers associated with RCPH symptom severity.

Main Methods:

• Prospective multicenter study of 120 patients.
• Systematic assessment of high-resolution CT scans for seven parameters: contact point type/intensity, septal deviation, concha bullosa morphology, mucosal edema, turbinate hypertrophy, and anatomical variants.
• Multivariate analysis to identify predictors of pain severity.

Main Results:

• CP-I and CP-II were predominant contact point patterns.
• Moderate contact intensity and significant septal deviation were common findings.
• Focal mucosal edema at the contact point was independently associated with increased pain severity (p=0.003).
• The developed framework showed substantial to excellent interobserver reliability (κ = 0.76-0.91).

Conclusions:

• The CT imaging framework provides reliable assessment for RCPH.
• Key predictors of higher pain scores include moderate-severe contact intensity, focal mucosal edema, and specific septal deviation patterns.
• This classification system supports quantitative imaging, automated phenotyping, and personalized treatment for RCPH.