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Factors associated with poor outcomes in migraine surgery
Hongyang Pi, BS; Kyle Lineberry, MD; Bahman Guyuron, MD
University Hospitals Cleveland Medical Center
2017-02-14
Presenter: Hongyang Pi
Affidavit:
The work on this project represents the original work of the medical student, resident and faculty.
Director Name: Hooman Soltanian
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Background:
Migraine surgery can offer significant improvement or elimination of migraine headache (MH) in almost 90% of patients. Patient selection, correct identification of trigger sites and complete decompression are key factors to obtain positive outcomes. The aim of this study was to explore other patient factors that may be associated with less favorable outcomes.
Methods:
A retrospective review of patients operated on by the senior author was conducted. Pre- and post-operative migraine frequency, severity, and duration were reviewed. Patients that experienced no subjective change or subjective worsening in these parameters were included in the study. Gender, age, and surgery site were compared with pre- and post-operative migraine questionnaires and analyzed for any statistically significant associations less favorable outcomes.
Results:
A total of 918 migraine patients were reviewed. 89 patients reported no improvement in frequency of MH; 60 in severity and 147 in duration. There were no statistically significant gender differences between responders and non-responders. Non-responders are significantly younger than responders (p < 0.05). Patients with migraines at trigger site 2 are most likely to improve with surgery. Patients with trigger site 5 headaches are the least likely to improve.
Conclusion
The characteristics of MH surgery non-responders can help guide surgical planning and set realistic expectations for patients.
