Saturday, October 12, 2013
INTRODUCTION: The senior author has developed surgical techniques to deactivate common migraine headache trigger sites. Site II surgery targets temporal migraine headaches (TMH) and involves avulsion of the zygomaticotemporal branch of the trigeminal nerve. The objective of this study is to examine the effect of site II surgery on migraine triggers and associated symptoms.
METHODS: Charts of 235 patients receiving surgery for TMH by a single surgeon over a 10-year period who were followed at least 1 year were analyzed. Median regression adjusted for age, sex, and follow-up time was used to determine post-operative reduction in temporal-specific Migraine Headache Index (TMHI), which is the product of migraine duration, frequency, and severity. The association between individual symptom or trigger resolution and TMHI reduction was studied by logistic regression.
RESULTS: Benefit of site II surgery includes significant reduction of TMHI from the pre- to post-operative period regardless of age, sex, and follow-up time (p<0.01). Additionally, symptoms resolving with successful site II surgery include nausea, photophobia and phonophobia, difficulty concentrating, vomiting, blurry vision, and eyelid ptosis (p<0.05). Triggers resolving with successful site II surgery include letdown after stress, air travel, missed meals, bright lights, loud noises, fatigue, weather change, and certain smells (p<0.05).
CONCLUSION: Surgical deactivation of TMH is effective in reducing migraine duration, frequency, and severity, 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 trigger site identification.