hyperactive Corrugator Supercilii muscle, Depressor Supercilii muscle and ... selective incision of hyperactive surrounding muscles: Occipital, Trapezius, ...
Department of Surgical Sciences, Plastic Surgery Division, University of Parma. Cutaneous, Mininvasive, Regenerative and Plastic Surgery Unit, Parma University Hospital, Parma, Italy. Dir.: Prof. Edoardo Raposio
INTRODUCTION Recent insights into the pathogenesis of migraine headache substantiate a neuronal hyper-excitability and inflammation involving compressed peripheral cranio-facial nerves, and these trigger points can be eliminated by surgery. We report the elimination or improvement in forehead migraine headaches through surgical decompression of the peripheral branch of trigeminal nerve (N. supratrochlearis and Supraorbitalis) following selective incision of hyperactive Corrugator Supercilii muscle, Depressor Supercilii muscle and Procerus muscle and in occipital migraine headaches through surgical decompression of cervical plexus - C2 (Lesser and Greater Occipital Nerves) following selective incision of hyperactive surrounding muscles: Occipital, Trapezius, Sternocleidomastoid, Splenius and Semispinalis Capitis.
PATIENTS AND METHODS Fifty-six patients who complained of chronic migraine headaches underwent: a frontal bilateral selective myotomy procedure (n.43) of Procerus, Depressor Supercilii and Corrugator Supercilii muscles by means of video-assisted endoscopic surgery, or an occipital selective myotomy procedure (n.13) of Occipital, Trapezius, Sternocleidomastoid and Semispinalis Capitis muscles by means of open surgery.
RESULTS Of the 56 patients included in the study (range, 18 to 72 years), 42 were women and 14 were men. All of 56 patients underwent surgery, 56 patients were followed for 6 months and 15 of them for 2 years. After 6-months-long follow-up, we obtained the following results: 22 (39.4%) of 56 patients observed complete elimination, 24 (42.8 %) experienced significant improvement (at least 50% reduction in intensity or frequency), and 10 (17.8%) did not notice any change. The minimally invasive approach yielded positive response in 46 of 56 patients (82.2%), confirming the validity of the procedure. After 2-years-long follow-up, our approach yielded positive response in 14 of 15 patients (93.3%): 5 of 15 patients (33.3%) observed complete recovery, 9 of 15 patients (60%) experienced significant improvement (at least 50% reduction in intensity or frequency), and 1 (6.6%) did not notice any change. Left decompressed supraorbital nerve
Right exposed occipital nerves
