Techinique in Frontal Migraine Surgery with Minimally Invasive and Endoscopic | Abstract

Plastic Surgery: Case Studies


Techinique in Frontal Migraine Surgery with Minimally Invasive and Endoscopic

Gianluigi Lago

Introduction/Statement of the Problem: Migraine Headache (MH) is a very common disorder affecting 1.7–4% of the world’s adult population. The first line therapy for these patients is usually a combination of conservative treatments. Despite this large variety of options available, some patients remain refractory. For such group, migraine surgery might offer a definitive solution for their medical condition. In these patients, migraine is usually caused by extracranial nerve compression due vascular, fascial or muscular structures nearby. In patients suffering from frontal migraine nerve decompression can be achieved with selective myotomies of procerus, corrugator and depressor supercilii muscles. Methodology & Theoretical Orientation: From 2011, in our Plastic Surgery Unit at the University of Parma, Italy, we performed 69 frontal myotomies in patients suffering from frontal migraine. 64 were bilateral procedures and 5 were monolateral (3 right, 2 left). We carried out these surgical procedures with a minimally invasive, single-access, endoscopic technique. All patients have been hospitalized and discharged the day after the procedure. Findings: In patient treated with endoscopic frontal myotomies, positive results were observed in 94% of the patients (32% complete elimination, 62% partial improvement). 6% of the patients did not report any improvement of their condition. The most commonly observed adverse event was post-operative frontal edema. Conclusion & Significance: Frontal migraine is a common and debilitating condition that can be treated successfully with minimally invasive surgical procedures. Our single-access endoscopic technique provided satisfactory results with minimal post-operative recovery time for the patients