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Factors Contributing to Migraine Headache Surgery Failure and Success
Kelsey Larson BA, Michelle Lee MD, Bahman Guyuron MD
University Hospitals Cleveland
2010-03-09
Presenter: Kelsey Larson
Affidavit:
Director Name:
Author Category: Resident/Fellow
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Background: Surgical treatment of migraines at various trigger sites has been shown to reduce migraine frequency, intensity and duration. The purpose of this study is to identify factors which contribute to migraine surgery failure.
Methods: Retrospective chart review was performed on patients who underwent migraine surgery by the senior author from January 1, 2001-December 31, 2008. The study population was subdivided into two groups: surgery success and surgery failure. Patients had at least 1 year postoperative follow-up and completed migraine-specific questionnaires during follow-up. Charts and questionnaires were analyzed retrospectively. 36 data points were collected for each patient.
Results: 382 patients underwent migraine surgery during the inclusion timeframe. 66 patients were in the migraine surgery success group, defined as complete elimination of migraine headaches postoperatively. 36 patients were in the migraine surgery failure group, defined as <50% reduction in frequency, intensity or duration of migraines postoperatively. Significant differences between surgery success (S) and failure (F) groups are: migraine age of onset (S:25.4±11.4 years versus F:20.5±10.3 years, p=0.04); frequency of intra-operative complications (S:0% versus F:9.1%, p=0.04); surgery site I (S:83.3% versus F: 50%, p=0.0006) or site II (S:75.8% versus F:50%, p=0.015); one surgical site (S:24.2% versus F:52.8%, p=0.0048); 1-2 surgical sites (S:50.0% versus F:72.2%, p =0.04); and four surgical sites (S:34.7% versus F:8.3%, p = 0.04).
Conclusions: Factors associated with migraine surgery failure are younger age of migraine onset, intra-operative complications, and two or fewer surgical sites. Factors associated with migraine surgery success are surgery at site I or II, and all four surgical sites.
