Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:


Non-endoscopic migraine surgery provides significant symptom relief


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

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:

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

More articles from Health and Medicine:

nachricht Advanced analysis of brain structure shape may track progression to Alzheimer's disease
26.10.2016 | Massachusetts General Hospital

nachricht Indian roadside refuse fires produce toxic rainbow
26.10.2016 | Duke University

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: Etching Microstructures with Lasers

Ultrafast lasers have introduced new possibilities in engraving ultrafine structures, and scientists are now also investigating how to use them to etch microstructures into thin glass. There are possible applications in analytics (lab on a chip) and especially in electronics and the consumer sector, where great interest has been shown.

This new method was born of a surprising phenomenon: irradiating glass in a particular way with an ultrafast laser has the effect of making the glass up to a...

Im Focus: Light-driven atomic rotations excite magnetic waves

Terahertz excitation of selected crystal vibrations leads to an effective magnetic field that drives coherent spin motion

Controlling functional properties by light is one of the grand goals in modern condensed matter physics and materials science. A new study now demonstrates how...

Im Focus: New 3-D wiring technique brings scalable quantum computers closer to reality

Researchers from the Institute for Quantum Computing (IQC) at the University of Waterloo led the development of a new extensible wiring technique capable of controlling superconducting quantum bits, representing a significant step towards to the realization of a scalable quantum computer.

"The quantum socket is a wiring method that uses three-dimensional wires based on spring-loaded pins to address individual qubits," said Jeremy Béjanin, a PhD...

Im Focus: Scientists develop a semiconductor nanocomposite material that moves in response to light

In a paper in Scientific Reports, a research team at Worcester Polytechnic Institute describes a novel light-activated phenomenon that could become the basis for applications as diverse as microscopic robotic grippers and more efficient solar cells.

A research team at Worcester Polytechnic Institute (WPI) has developed a revolutionary, light-activated semiconductor nanocomposite material that can be used...

Im Focus: Diamonds aren't forever: Sandia, Harvard team create first quantum computer bridge

By forcefully embedding two silicon atoms in a diamond matrix, Sandia researchers have demonstrated for the first time on a single chip all the components needed to create a quantum bridge to link quantum computers together.

"People have already built small quantum computers," says Sandia researcher Ryan Camacho. "Maybe the first useful one won't be a single giant quantum computer...

All Focus news of the innovation-report >>>



Event News

#IC2S2: When Social Science meets Computer Science - GESIS will host the IC2S2 conference 2017

14.10.2016 | Event News

Agricultural Trade Developments and Potentials in Central Asia and the South Caucasus

14.10.2016 | Event News

World Health Summit – Day Three: A Call to Action

12.10.2016 | Event News

Latest News

How nanoscience will improve our health and lives in the coming years

27.10.2016 | Materials Sciences

OU-led team discovers rare, newborn tri-star system using ALMA

27.10.2016 | Physics and Astronomy

'Neighbor maps' reveal the genome's 3-D shape

27.10.2016 | Life Sciences

More VideoLinks >>>