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Outcome Comparison of Endoscopic and Transpalperbral Decompression for Treatments of Frontal Migraine Headaches
Mengyuan T Liu, Harvey Chim, Bahman Guyuron
Case Western Reserve University Medical School/Case Medical Center
2012-01-19
Presenter: Mengyuan T Liu
Affidavit:
This study represents 80% of the student's original work.
Director Name: Bahman Guyuron, MD, FACS
Author Category: Student
Presentation Category: Clinical
How does this presentation meet the established conference educational objectives?
This study addresses new techniques in decompressing the supraorbital and supratrochlear nerves for frontal migraine headaches.
How will your presentation be used by practicing physicians in the audience?
There are currently two different techniques for decompression of frontal migraine headaches: transpalpebral and endoscopic. Our study demonstrates that the endoscopic technique is significantly more successful at eliminating frontal migraine headaches than the transpalpebral technique. Participating physicians will hopefully begin to employ the endoscopic technique exclusively in their practices. We also discuss specific maneuvers performed during each technique that should be incorporated to maximize release of the nerves.
Background:
This study was designed to compare the efficacy of the transpalpebral versus endoscopic approach to decompression of the supraorbital and supratrochlear nerves in patients with frontal migraine headaches.
Methods:
The medical charts of 253 patients who underwent surgery for frontal migraine headaches were reviewed. These patients either underwent transpalpebral nerve decompression (TPND, n=62) or endoscopic nerve decompression (END, n=191). The preoperative and >12 month postoperative migraine frequency, duration, and intensity were analyzed to determine the success of the surgeries.
Results:
Forty-nine (79%) of 62 patients in the TPND group and 170 (89%) of 191 patients who underwent END experienced a successful outcome (at least 50% decrease in migraine frequency, duration, or intensity) after one year from surgery. END had a significantly higher success rate than TPND (p<0.05). Thirty-two (52%) patients in the TPND group and 128 (67%) patients who underwent END observed elimination of migraine headaches. The elimination rate was significantly higher in the END group than in the TPND group (p<0.03).
Conclusions:
END was found to be more successful at reducing or eliminating frontal migraine headaches than TPND and should be selected as the first choice whenever it is anatomically feasible.
