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Functional Endoscopic Sinus Surgery as a Component in the Comprehensive Surgical Management of Migraine Headaches

Mengyuan T Liu, BS, Harvey Chim, MD, Bahman Guyuron, MD FACS, David W Stepnick, MD FACS
Case Western Reserve University
2013-02-09

Presenter: Mengyuan T Liu

Affidavit:
The above work is 80% the work of the presenter.

Director Name: Bahman Guyuron

Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial

Background: Irritation of sensory nerve endings through obstruction of secretion flow and chronic sinusitis may contribute to the pathogenesis of retro-orbital migraine headaches. The purpose of this study was to determine if sinus surgery benefited the patients with migraine headaches.

Methods: The medical charts of 44 patients who underwent endoscopic sinus surgery for the purpose of migraine headache relief were reviewed. The preoperative and >12-month postoperative retro-orbital migraine frequency, duration, and intensity were analyzed to determine the success of the surgeries.

Results: Following endoscopic sinus surgery, 33 (75.0%) of the 44 patients experienced a successful reduction in retro-orbital migraine headaches (at least 50% decrease in migraine frequency, duration, or intensity), with 9 (20.5%) experiencing complete elimination. The mean postoperative pain frequency and severity were significantly reduced (p < 0.0001) after surgery. The most common sinus surgery was ethmoidectomy (38 of 44 patients), followed by maxillary antrostomy (35 of 44 patients). Eleven (25%) of the 44 patients underwent secondary sinus surgery to further reduce migraine headaches.

Conclusions: The results of this study provide evidence that sinus pathology is a significant contributor to migraine headaches and that functional endoscopic sinus surgery is effective at relieving retro-orbital migraine headaches.

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