title: Outcome comparison of endoscopic and transpalpebral decompression for treatment of frontal migraine headaches.
abstract: BACKGROUND
  This study was designed to compare the efficacy of the transpalpebral versus endoscopic approach to decompression of the supraorbital and supratrochlear nerves in patients with frontal migraine headaches.
  
  
  METHODS
  The medical charts of 253 patients who underwent surgery for frontal migraine headaches were reviewed. These patients underwent either transpalpebral nerve decompression (n = 62) or endoscopic nerve decompression (n = 191). Preoperative and 12-month or greater postoperative migraine frequency, duration, and intensity were analyzed to determine the success of the surgeries.
  
  
  RESULTS
  Forty-nine of 62 patients (79 percent) in the transpalpebral nerve decompression group and 170 of 191 patients (89 percent) who underwent endoscopic nerve decompression experienced a successful outcome (at least a 50 percent decrease in migraine frequency, duration, or intensity) after 1 year from surgery. Endoscopic nerve decompression had a significantly higher success rate than transpalpebral nerve decompression (p < 0.05). Thirty-two patients (52 percent) in the transpalpebral nerve decompression group and 128 patients (67 percent) who underwent endoscopic nerve decompression observed elimination of migraine headaches. The elimination rate was significantly higher in the endoscopic nerve decompression group than in the transpalpebral nerve decompression group (p < 0.03).
  
  
  CONCLUSIONS
  Endoscopic nerve decompression was found to be more successful at reducing or eliminating frontal migraine headaches than transpalpebral nerve decompression and should be selected as the first choice whenever it is anatomically feasible.
  
  
  METHODS
  Therapeutic, III.
authors.affiliation: Cleveland, Ohio From the Department of Plastic Surgery, University Hospitals Case Medical Center, and Case Western Reserve University School of Medicine.
authors.forename: Mengyuan T
authors.initials: MT
authors.lastname: Liu
authors.forename: Harvey
authors.initials: H
authors.lastname: Chim
authors.forename: Bahman
authors.initials: B
authors.lastname: Guyuron
mesh_terms: D000328:Adult; D019299:Decompression, Surgical; D004724:Endoscopy; D005260:Female; D005546:Forehead; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000503:physiopathology / Q000601:surgery*; D018482:Muscle, Skeletal / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D014276:Trigeminal Nerve / Q000503:physiopathology*