Frontal site surgery for chronic migraine therapy.

Giorgio Raposio, Andrea Antonini, Alessandro Gualdi, Edoardo Raposio
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Abstract

Background: According to the most current theories, chronic inflammation of some cranial nerves give rise to an inflammatory chain that would result in migraines. As for frontally located attacks, the nerves involved are two (on each side): the supraorbital and the supratrochlear. Surgical treatment includes complete neurolysis of both of these nerves.

Methods: In this work, we describe our experience with this type of surgery. From 2011 to 2022, we treated 98 cases suffering from chronic migraine not responsive to drugs with frontal localization. The results were evaluated through a specific questionnaire three months and one year after surgery.

Results: After three months post-surgery, we observed a success rate (reduction of monthly attacks equivalent to or greater than 50%) in 87% of patients (32% complete recovery). These results were essentially confirmed one year after surgery. The rare complications (mainly paresthesias and dysesthesias of the frontal area) have always resolved spontaneously within a few months.

Conclusion: The surgical approach allowed to obtain good therapeutic results with a low rate of complications.

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用于治疗慢性偏头痛的额部手术。
背景:根据最新理论,某些颅神经的慢性炎症会引发炎症链,从而导致偏头痛。至于位于前部的偏头痛发作,涉及的神经有两条(每侧各一条):眶上神经和耳上神经。手术治疗包括完全切除这两条神经:在这项工作中,我们介绍了此类手术的经验。从 2011 年到 2022 年,我们治疗了 98 例对药物无反应的额叶定位慢性偏头痛患者。术后三个月和一年,我们通过特定的问卷对手术效果进行了评估:手术后三个月,我们观察到87%的患者(32%完全康复)获得了成功(每月发作次数减少相当于或超过50%)。这些结果在术后一年基本得到了证实。罕见的并发症(主要是额叶区域的麻痹和疼痛)总是在几个月内自行缓解:手术方法取得了良好的治疗效果,并发症发生率较低。
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