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In-Depth Review of Symptoms, Triggers, and Treatment of Temporal Migraine Headaches (Site II)

Kurlander, David E. B.S.; Punjabi, Ayesha B.S.; Liu, Mengyuan T. B.S.; Sattar, Abdus Ph.D.; Guyuron, Bahman M.D.

Plastic and Reconstructive Surgery: April 2014 - Volume 133 - Issue 4 - p 897–903
doi: 10.1097/PRS.0000000000000045
Reconstructive: Head and Neck: Original Articles
Press Release

Background: This study was designed to report the details of the technique and assess the efficacy of surgical deactivation of temporal-triggered migraine headaches. It also examined the effect of surgical deactivation of temporal-triggered migraine headaches on migraine triggers and associated symptoms besides the pain.

Methods: The authors analyzed the charts of 246 patients receiving surgery for temporal-triggered migraine headaches by a single surgeon (B.G.) over a 10-year period, who were followed for at least 1 year. Median regression adjusted for age, sex, and follow-up time was used to determine postoperative reduction in temporal-specific migraine headache index, which is the product of frequency, severity, and duration. The association between individual symptom or trigger resolution and index value reduction was studied by logistic regression. Details of the surgical treatment are discussed.

Results: Eighty-five percent of patients reported a successful surgery (≥50 percent improvement of headache index) at least 12 months after surgery (mean follow-up, 3 years). Fifty-five percent reported complete elimination of temporal migraine headache. Symptoms resolving with successful site II surgery included nausea, photophobia, phonophobia, difficulty concentrating, vomiting, blurry vision, and eyelid ptosis (p < 0.05). Triggers resolving included letdown after stress, air travel, missed meals, bright lights, loud noises, fatigue, weather change, and certain smells (p < 0.05).

Conclusions: Surgical deactivation of temporal-triggered migraine headaches is effective regardless of age, sex, or follow-up time. Successful site II surgery is associated with changes in specific symptoms and triggers. This information can assist in trigger avoidance and contribute to constellations used for temporal-triggered migraine headaches trigger-site identification.


Cleveland, Ohio

From the Department of Plastic Surgery, University Hospitals Case Medical Center.

Received for publication May 21, 2013; accepted October 22, 2013.

Disclosure: The authors have no financial interest to declare in relation to the content of this article.

Bahman Guyuron, M.D., 29017 Cedar Road, Cleveland (Lyndhurst), Ohio 44124,

©2014American Society of Plastic Surgeons