Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Non-endoscopic migraine surgery provides significant symptom relief

29.07.2014

More than half of those in small Massachusetts General study report elimination of all migraine symptoms

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 have focused on developing ways to access migraine trigger points – specific sites of nerve compression that differ from patient to patient – through open incisions used in several cosmetic procedures.

Patients included in the current study all had chronic migraines that had been confirmed by a full neurological exam and had not responded to standard medical therapies. Previous symptom relief from treatment with Botox or nerve blocks, which would support a role for nerve compression, was required for inclusion in the study. Trigger points were identified based on patients' symptoms and histories, including response to previous procedures; and surgery was performed to free those sites from compressing muscles, connective tissue, blood vessels or bony structures.

The study analyzed a total of 43 procedures performed on 35 patients. Of those procedures, 90.1 percent resulted in symptom resolution – defined as a greater than 50 percent improvement in the frequency, duration and severity of migraine pain. Complete elimination of migraine symptoms was produced by 51.3 percent of successful procedures; 28.2 percent resulted in a greater than 80 percent improvement, and 20.5 percent produced a 50 to 80 percent improvement.

Austen stresses that selecting the appropriate patients for this procedure – including preliminary evaluations by a neurologist specializing in migraines – is essential. "We're still at the early stages of developing this concept and are now conducting a prospective study to find better ways of evaluating which patients we can help. We need to develop more evidence that this approach will be successful in the hands of surgeons at many different centers. No one is claiming that this is a cure for migraines, but the results of our study and others clearly indicate that this procedure can make a big difference in the lives of the right patients."

###

Austen is an associate professor of Surgery at Harvard Medical School. Co-authors of the paper are Lisa Gfrerer, MD, lead author; Daniel Maman, MD, and Oren Tessler, MD, all of the MGH Division of Plastic and Reconstructive Surgery. The manuscript version of the report is currently available at http://journals.lww.com/plasreconsurg/Abstract/publishahead/Non__Endoscopic_Deactivation_of_Nerve_Triggers_in.99477.aspx.

Massachusetts General Hospital, founded in 1811, is the original and largest teaching hospital of Harvard Medical School. The MGH conducts the largest hospital-based research program in the United States, with an annual research budget of more than $785 million and major research centers in HIV/AIDS, cardiovascular research, cancer, computational and integrative biology, cutaneous biology, human genetics, medical imaging, neurodegenerative disorders, regenerative medicine, reproductive biology, systems biology, transplantation biology and photomedicine.

Cassandra Aviles | Eurek Alert!
Further information:
http://www.massgeneral.org/

Further reports about: Reconstructive headaches investigators migraine migraines muscles nerves surgery symptoms

More articles from Health and Medicine:

nachricht Understanding the Body’s Response to Worms and Allergies
24.04.2015 | University of Manchester

nachricht Caring for blindness: A new protein in sight?
22.04.2015 | NSERM (Institut national de la santé et de la recherche médicale)

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Fast and Accurate 3-D Imaging Technique to Track Optically-Trapped Particles

KAIST researchers published an article on the development of a novel technique to precisely track the 3-D positions of optically-trapped particles having complicated geometry in high speed in the April 2015 issue of Optica.

Daejeon, Republic of Korea, April 23, 2015--Optical tweezers have been used as an invaluable tool for exerting micro-scale force on microscopic particles and...

Im Focus: NOAA, Tulane identify second possible specimen of 'pocket shark' ever found

Pocket sharks are among the world's rarest finds

A very small and rare species of shark is swimming its way through scientific literature. But don't worry, the chances of this inches-long vertebrate biting...

Im Focus: Drexel materials scientists putting a new spin on computing memory

Ever since computers have been small enough to be fixtures on desks and laps, their central processing has functioned something like an atomic Etch A Sketch, with electromagnetic fields pushing data bits into place to encode data.

Unfortunately, the same drawbacks and perils of the mechanical sketch board have been just as pervasive in computing: making a change often requires starting...

Im Focus: Exploding stars help to understand thunderclouds on Earth

How is lightning initiated in thunderclouds? This is difficult to answer - how do you measure electric fields inside large, dangerously charged clouds? It was discovered, more or less by coincidence, that cosmic rays provide suitable probes to measure electric fields within thunderclouds. This surprising finding is published in Physical Review Letters on April 24th. The measurements were performed with the LOFAR radio telescope located in the Netherlands.

How is lightning initiated in thunderclouds? This is difficult to answer - how do you measure electric fields inside large, dangerously charged clouds? It was...

Im Focus: On the trail of a trace gas

Max Planck researcher Buhalqem Mamtimin determines how much nitrogen oxide is released into the atmosphere from agriculturally used oases.

In order to make statements about current and future air pollution, scientists use models which simulate the Earth’s atmosphere. A lot of information such as...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

HHL Energy Conference on May 11/12, 2015: Students Discuss about Decentralized Energy

23.04.2015 | Event News

“Developing our cities, preserving our planet”: Nobel Laureates gather for the first time in Asia

23.04.2015 | Event News

HHL's Entrepreneurship Conference on FinTech

13.04.2015 | Event News

 
Latest News

Electrons Move Like Light in Three-Dimensional Solid

24.04.2015 | Materials Sciences

Connecting Three Atomic Layers Puts Semiconducting Science on Its Edge

24.04.2015 | Materials Sciences

Understanding the Body’s Response to Worms and Allergies

24.04.2015 | Health and Medicine

VideoLinks
B2B-VideoLinks
More VideoLinks >>>