Plastic, Reconstructive and Aesthetic Surgeon Assoc. Dr. Karaca Başaran gave information on the subject. Migraine, which haunts many people from their lives, is estimated to be seen in roughly 15 percent of people today. Migraines attacks can often be controlled with medication. However, in some patients, adequate control or prevention may not be achieved with any medication. Some patients whose pain is controlled with medications are disturbed by the side effects of the drugs.
Nerve Relaxation as a Cause of Migraine Headaches
In some patients, the cause of migraines is irritation (stimulation) of some nerve endings in the head and neck. The stimulation is often caused by the muscles through which these nerves pass. The muscles compress the nerve, causing pressure and can eventually lead to a migraine attack. These nerve endings have now been discovered in many areas of the head and neck.
How Does Migraine Surgery Work?
Migraine surgery works with the principle of reducing the compression created by the muscles in the nerves. Reducing the pressure on the nerves can prevent the onset of migraine attacks, or at least weaken the trigger, causing migraines to occur less frequently and become milder. Although these trigger points can be determined first by making Botox injections to the trigger point regions, most of the time the main regions can be determined from the patient's complaints. When the patient has a positive response to botox treatment (relief of migraine), these trigger points can be surgically treated through small incisions hidden in the scalp. At this point, the plastic surgeon can step in and perform these procedures through small incisions with camera surgery (laparoscopic) method.
Success Rates of Migraine Surgery
Recent studies show that one-third of patients make a full recovery. However, in 90 percent of cases, the number, severity and duration of migraine attacks are significantly reduced in patients.
Trigger Areas in Migraine Surgery
The peripheral trigger theory of migraines was discovered after Botox applications to this area to prevent wrinkles between the eyebrows. If the majority of headaches start around the eyebrows or between the eyes, these are known as frontal or forehead migraines. In frontal migraines, the supraorbital nerve that comes out through a hole in the forehead is found compressed by the corrugator muscle.
Temporal Area (temple)
If the pain begins in the temporal area or the side of the head, these are known as temporal migraines. Temporal migraines are caused by the compression of the zygomatico-temporal nerve by the temporalis muscle as it moves towards the skin.
Occipital (nape) area
If most headaches start at the back of the head at the base of the skull, these are known as occipital migraines. Patients with occipital migraine also frequently experience pain in the neck and upper back.
Nasal Zone (Nasal migraine)
If most headaches originate from the back of the eyes and around the nose, these are known as nasal migraines. It occurs due to compression of the nerves in the nose with the curvature of the nasal septum (deviation). Contrary to all other zones, Botox cannot be used to determine this trigger point. Intra-nasal examination and tomography are required to understand whether the cause of migraines is severe septal curvature.
Some migraine surgery patients have more than one area at the source of migraine headaches.
After Migraine Surgery
All incisions made for migraine surgery, whether in the upper eyelid or hair line, are closed with melting stitches. There is no need for bandages or wound care. On average, on the second day, migraine surgery patients can take a bath and wash their hair. There may be mild discomfort in the incision areas of the scalp, but there is little swelling and bruising. When upper eyelid incisions are used, there may be moderate swelling in the upper eyelid one week after surgery.
There are no physical restrictions or instructions after surgery. There may be redness, slight ache or numbness in the incisions for several months. Although most patients experience immediate relief from migraine headaches, weeks to months may be required for the full benefit of migraine surgery.