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Use of Doppler Signal to Confirm the Migraine Trigger Site
Guyuron, Bahman; Long, Tobias; Wirtz, Emily; Riazi, Hooman
Guyuron, Bahman
Case Western/University Hospitals
2014-03-15
Presenter: Tobias Long
Affidavit:
The following abstract represents the original work of the resident.
Director Name: Bahman Guyuron
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Aesthetics
Introduction:
The auriculotemporal nerve has been indicated as one of the potential trigger sites for migraine headaches in some patients. Our cadaver studies and clinical experience have demonstrated intertwining of the superficial temporal artery and the auriculotemporal nerve, potentially triggering headaches The goal of this study was to determine if ultrasound Doppler can be used pre-operatively to determine whether the superficial temporal artery is present at the most intense temporal pain site.
Methods:
A pre-operative Doppler examination was performed on 32 patients (51 sides) prior to auriculotemporal nerve migraine surgery, aided by patients pointing to the area of the most intense headache site. The incidence of the intra-operative presence of the superficial temporal artery in the most intense pain site was then compared to the Doppler examination results.
Results:
The presence of a positive Doppler signal over the area of most intense temporal pain identified by the patient pre-operatively correlated with intra-operative presence of the artery in 100% of the patients. Doppler signal was noted on 33 sites and arterectomy was carried out in all 33 sites with positive outcomes.
Conclusion
A simple pre-operative Doppler detection of arterial signal is a safe and very reliable method of determining whether the superficial temporal artery or its branches are present in the most intense pain site which can lead to successful decompression of this nerve with minimal dissection under local anesthesia as an office procedure.
