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The Role of Pre-Operative Migraine Headache Frequency on Surgical Outcomes
Samantha Zwiebel, Sima Molavi, Haley Gittleman, Brendan Alleyne, Bahman Guyuron
University Hospitals Case Medical Center
2014-03-15
Presenter: Samantha Zwiebel
Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting. Please make a statement as to how much of the above work represents the original work of the resident.
Director Name: Hooman Soltanian
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Background: The Global Burden of Disease ranks migraine headache (MH) among the most disabling of conditions, and in the United States, is one of the top 5 causes of visits to the emergency room. As migraineurs turn to surgical treatment for relief, it is unknown how migraine frequency influences outcomes.
Methods: In total, 488 patients prospectively completed the migraine headache questionnaires preoperatively and at least 11 months postoperatively. Patients were grouped into 3 cohorts based on migraine frequency of 1-14 a month (episodic), 15-29 a month (chronic), or at least daily (daily). Statistics were performed with paired t-tests, linear regression, and ANOVA with Tukey's HSD test.
Results: All groups experienced a significant benefit from surgery in terms of frequency, duration, and severity of MH, and Migraine Headache Index (MHI). Patients experienced significantly different final outcomes based on their frequency cohort with respect to duration (p=0.02), frequency (p<0.0001), and MHI (p<0.0001). However, when the pre-operative score is controlled for, the only significant difference between cohorts occurred in MHI among daily migraineurs compared to episodic (p=0.0003) and chronic (p=0.0008) migraineurs. No other significant findings persisted.
Conclusions: All cohorts, regardless of their frequency of MH, achieved significant improvement in frequency, duration, severity, and MHI. The groups also achieved statistically different final outcomes, but no group benefits more than the other when improvement is quantified, and patients can expect similar relative improvement.
