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A Prospective Randomized Outcomes Comparison of Two Temple Migraine Trigger Site Deactivation Techniques for Migraine Headaches
Donald James (DJ) Harvey MD
Bahman Guyuron MD
Deborah Reed MD
University Hospitals Case Medical Center
2014-03-14
Presenter: DJ Harvey MD
Affidavit:
Director Name: Hooman Soltanian MD
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: General Reconstruction
Purpose: This study was conducted to compare the outcomes of surgical decompression
versus avulsion of the zygomaticotemporal branch of the trigeminal nerve (ZTBTN) for
treatment of frontal migraine headaches (MH).
Method: 20 patients with bilateral temporal MH were randomized to undergo avulsion
of the ZTBTN on one side and decompression via fasciotomy and removal of the
zygomaticotemporal artery on the other side. The results were analyzed after minimum
12 months follow up
Results: 19 patients completed the study. Ninety two percent of the patients
observed greater than 50% improvement in frequency, severity, and duration in the
operative sites. Sixty percent experienced complete elimination of symptoms at the
site. The decompression group's preoperative and postoperative changes are as
follows: frequency was 14.6 per month to 1.9 per month, severity was 7.0 to 2.6,
duration in days was from 0.4 to 0.2, and the Migraine Headache Index (MHI) score
was 42 to 2.9. The neurectomy group's preoperative to postoperative changes are:
frequency was 14.2 per month to 2.2 per month, severity was 6.8 to 2.9, migraine
duration in days was 0.4 to 0.23, and MHI score was 41 to 3. There was no
statistical significance between the two groups.
Conclusion: Neurectomy and decompression of the ZTBTN are appropriate methods for
treatment of migraine II trigger sites with no significant difference in the
outcomes between the two procedures. Performing decompression as the first option
leaves neurectomy as another option, should decompression fail to provide sufficient
relief.
