A revised version of a surgical procedure to treat severe chronic migraine headaches led to significant symptom relief more than 90 percent of the time in patients treated at Massachusetts General Hospital (MGH). Physicians from the MGH Division of Plastic and Reconstructive Surgery report that more than half of 35 patients treated with the non-endoscopic procedure all of whom had headaches associated with compression of craniofacial nerves reported complete symptom relief a year later. The team's paper has received advance online publication in the journal Plastic and Reconstructive Surgery.
"We confirmed that surgery through standard incisions used for cosmetic procedures can be very effective in treating some of the most severe cases of chronic migraine," says William G. (Jay) Austen, Jr., MD, chief of Plastic and Reconstructive Surgery at MGH, who led the study. "While the earlier version of this procedure used an endoscope, not every patient is a candidate for endoscopic surgery, and not every surgeon has access to or experience with the equipment. We hope that this may increase the availability of this treatment.
Surgical treatment of migraine headaches was developed by Cleveland plastic surgeon Bahman Guyuron, MD, who had observed that some patients receiving cosmetic procedures of the forehead also had relief of migraine symptoms. Several studies by Guyuron and other investigators have supported the hypothesis that compression of the trigeminal and other craniofacial nerves can be an important trigger for migraine symptoms in some patients. The temporary symptom relief some patients experience through injections of botulinum toxin (Botox), which would release pressure from overactive muscles, further supports the theory.
Although Guyuron's original version of this procedure almost always used an endoscope to access and remove muscles contracting around specific nerves, the MGH team and other investigators h
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Massachusetts General Hospital