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Title: |
Surgical Elimination of Migraine Headache |
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Our research team recently reported that one of the triggers of migraine headache might be related to the compression of the trigeminal sensory nerve branches passing through the corrugator supercilii muscle in a subgroup of migraine patients. This prospective study was conducted to further evaluate the effects of surgical removal of the corrugator supercilii muscles and transection of the zygomaticotemporal branches of the trigeminal nerve on migraine headache. Prior to enrollment in the study, patients were diagnosed with migraine headache by the team’s neurologist, in accordance with the International Headache Society guidelines. Patients maintained an accurate daily diary of their headaches both prior to and after the treatments. The patients likely to have a positive outcome from surgery were identified using the injection of botulinum toxin (Botox). After two months, those with either an improvement (50% improvement in either frequency or intensity) or elimination of their headaches with Botox injections were selected to undergo surgery. Patients in whom the injection of Botox resulted in complete elimination of migraine headache underwent resection of the corrugator supercilii muscles only. Those who experienced significant improvement underwent transection of the zygomaticotemporal branch of the trigeminal nerve in addition to corrugator supercilii muscle resection. Temple soft tissues were repositioned to prevent recoaptation of the nerve endings.
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