Abstract
Migraine is a symptomatically heterogeneous condition, of which headache is just one manifestation. This disorder is associated with altered sensory thresholding, with hypersensitivity among migraine sufferers to different sensory inputs. Hence, we suggest that sensitivity to the gravitational receptor asymmetries seen in third window syndrome is triggering migraine symptoms via this hypersensitivity-associated mechanism. When measuring the impact of headache and migraine headache in the lives of patients with third window syndrome as well as the response to surgical intervention it is essential to incorporate a validated survey instrument into clinical practice. We have found that the six-item Headache Impact Test (HIT-6) in several different cohorts has demonstrated a highly statistically significant symptom improvement after surgical management of patients with third window syndrome. This review provides the background of the spectrum of sites of inner ear dehiscence resulting in third window syndrome, as well as other manifestations of the syndrome in the context of headache and migraine in these patients.