Efficacy of Surgical Treatment of Migraine Headaches Involving the Auriculotemporal Nerve (Site V).
Adult
Female
Follow-Up Studies
Humans
Male
Mandibular Nerve
/ surgery
Middle Aged
Migraine Disorders
/ diagnosis
Neurosurgical Procedures
/ methods
Pain Measurement
Patient Reported Outcome Measures
Postoperative Period
Preoperative Period
Retrospective Studies
Severity of Illness Index
Time Factors
Treatment Outcome
Journal
Plastic and reconstructive surgery
ISSN: 1529-4242
Titre abrégé: Plast Reconstr Surg
Pays: United States
ID NLM: 1306050
Informations de publication
Date de publication:
02 2019
02 2019
Historique:
entrez:
29
1
2019
pubmed:
29
1
2019
medline:
6
4
2019
Statut:
ppublish
Résumé
This study reports the surgical technique and efficacy of treatment for the less commonly studied auriculotemporal nerve (site V). The aim was to evaluate symptom relief and differences in migraine headache parameters (i.e., intensity, duration, and migraine-free days) after site V surgery. Patients undergoing site V surgery for auriculotemporal nerve-triggered migraine headaches were analyzed. Charts were reviewed retrospectively for age, sex, dates of surgery and follow-up, preoperative migraine data, types of surgery, and laterality. Postoperatively, patients completed a migraine headache questionnaire by means of office visit, phone, e-mail, or video conference. Forty-three patients were included in the study (36 women; median age, 50 years; interquartile range, 40 to 57 years). The majority of patients underwent bilateral surgery (n = 36) and reported site-specific relief (n = 34). The average follow-up was 17.2 months. The number of migraine-free days (per month) increased from 12.6 days before surgery to 25.1 days after surgery (median increase, 12.6 days; p < 0.005). Median migraine intensity scores decreased from 8.3 to 3.2 after surgery (median decrease, 5.1; p < 0.005) on 10-point severity scale. Migraine duration decreased from 1.2 hours/day to 0.5 hour/day after surgery (median decrease, 0.7 hour/day, p < 0.005). The median difference in migraine duration was the only value found not to be statistically significant, defined as p < 0.005. On both univariate and multivariate analyses, patient-reported site relief was significantly associated with decreased migraine intensity. Surgery for auriculotemporal nerve-triggered migraine headaches improves migraine headache parameters. This study is the first to examine surgical efficacy of this less commonly studied trigger site. Therapeutic, IV.
Sections du résumé
BACKGROUND
This study reports the surgical technique and efficacy of treatment for the less commonly studied auriculotemporal nerve (site V). The aim was to evaluate symptom relief and differences in migraine headache parameters (i.e., intensity, duration, and migraine-free days) after site V surgery.
METHODS
Patients undergoing site V surgery for auriculotemporal nerve-triggered migraine headaches were analyzed. Charts were reviewed retrospectively for age, sex, dates of surgery and follow-up, preoperative migraine data, types of surgery, and laterality. Postoperatively, patients completed a migraine headache questionnaire by means of office visit, phone, e-mail, or video conference.
RESULTS
Forty-three patients were included in the study (36 women; median age, 50 years; interquartile range, 40 to 57 years). The majority of patients underwent bilateral surgery (n = 36) and reported site-specific relief (n = 34). The average follow-up was 17.2 months. The number of migraine-free days (per month) increased from 12.6 days before surgery to 25.1 days after surgery (median increase, 12.6 days; p < 0.005). Median migraine intensity scores decreased from 8.3 to 3.2 after surgery (median decrease, 5.1; p < 0.005) on 10-point severity scale. Migraine duration decreased from 1.2 hours/day to 0.5 hour/day after surgery (median decrease, 0.7 hour/day, p < 0.005). The median difference in migraine duration was the only value found not to be statistically significant, defined as p < 0.005. On both univariate and multivariate analyses, patient-reported site relief was significantly associated with decreased migraine intensity.
CONCLUSIONS
Surgery for auriculotemporal nerve-triggered migraine headaches improves migraine headache parameters. This study is the first to examine surgical efficacy of this less commonly studied trigger site.
CLINICAL QUESTION/LEVEL OF EVIDENCE
Therapeutic, IV.
Identifiants
pubmed: 30688901
doi: 10.1097/PRS.0000000000005261
pii: 00006534-201902000-00041
doi:
Types de publication
Evaluation Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
557-563Commentaires et corrections
Type : CommentIn
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