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Neuropept ides are important neurotransmitters in nasal physiology and the increasing knowledge of their role in nasal diseases brings new therapeutic perspectives. The investigation of human nasal mucosa neuropeptides is based mostly on immunocytochemistry, a complex approach whose resulting factors may be variable. Aiming to make this kind of research available, an immunofluorescence approach for vasoactive intestinal peptide (VIP) in human nasal mucosa is proposed and evaluated. Study design: Transversal cohort. Material and Method: Human inferior turbinate samples were obtained at time of nasal surgery from eight patients. The samples were fixed in Zamboni solution (4% phosphate-buffered paraformaldehyde and 0.4% picric acid), snap-frozen and stored at -70ºC. 14 µm sections were then obtained. Immunofluorescence staining for VIP (Peninsula Laboratories) was performed and its images documented by conventional photography. The method's specificity, sensitivity and reproducibility of execution were evaluated. Additionally, the reproducibility of interpretation of results was evaluated through the comparison of staining scores (0 to 4) attributed to the images by six observers. Results:The results showed the approach to be very specific and sensible, besides being reproducible in its execution. The interpretation of results may depend on the observer's accuracy in judging immunofluorescence images, but it showed uniformity. Conclusion: The proposed method was highly useful for research purposes in neuropeptides in human nasal mucosa.

The causal relation between anatomical variations of the nose and headaches and facial pain is analyzed through literature review of the topic. The pathogenesis that can be involved in this relation proves to be wider than simple alteration of nasal septum and turbinates that can cause mechanical stimulus through contact between these structures, which covers infectious factors, neurogenic inflammation, correlation with migraines and the role of nasal obstruction. The clinical findings of a lot of authors including the test with topical anesthetic to prove this causal relation, the indication of surgical treatment, in addition to good results of this treatment, are reported. The mechanism of pain relief obtained through surgical correction of nasal septum and turbinate is discussed. These data make us conclude that there are multiple etiologic factors involved, which makes us question the fundamental role of the mechanical aspect.

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