title: A Prospective Randomized Outcomes Comparison of Two Temple Migraine Trigger Site Deactivation Techniques.
abstract: BACKGROUND
  The authors compared the reduction of migraine headache frequency, days, severity, and duration after surgical decompression versus avulsion of the zygomaticotemporal branch of the trigeminal nerve for treatment of temporal migraine headache.
  
  
  METHODS
  Twenty patients with bilateral temporal migraine headache were randomized to undergo avulsion of the zygomaticotemporal branch of the trigeminal nerve on one side and decompression via fasciotomy and removal of the zygomaticotemporal artery on the other side. Results were analyzed after a minimum of 12 months of follow-up.
  
  
  RESULTS
  Nineteen patients completed the study. The patients experienced greater than 50 percent improvement in frequency, migraine days, severity, and duration in 34 of the 38 operative sites (89 percent). Complete elimination of symptoms was noted in 21 of the 38 operative sites (55 percent). In the decompression group, migraine frequency was reduced from 14.6 to 2.2 per month, migraine days from 14.1 to 2.3, severity from 7.0 to 2.9, duration from 9.6 to 4.8 hours, and Migraine Headache Index score from 42 to 2.9. In the neurectomy group, frequency decreased from 14.2 to 1.9 per month, migraine days from 14.1 to 2.3, severity from 6.8 to 2.6, migraine duration from 10.1 to 5.3 hours, and the Migraine Headache Index score from 41 to 2.5. There was no statistical significance in reduced migraine headache frequency, days, severity, and duration between the two groups.
  
  
  CONCLUSIONS
  Neurectomy and decompression of the zygomaticotemporal branch of the trigeminal nerve are both appropriate treatment for temporal migraine headache. If decompression fails to provide sufficient relief, neurectomy is another option.
  
  
  METHODS
  Therapeutic, I.
authors.affiliation: Cleveland and Lyndhurst, Ohio From the Department of Plastic Surgery, University Hospital Case Medical Center; and the American Migraine Center.
authors.forename: Bahman
authors.initials: B
authors.lastname: Guyuron
authors.forename: Donald
authors.initials: D
authors.lastname: Harvey
authors.forename: Deborah
authors.initials: D
authors.lastname: Reed
mesh_terms: D000328:Adult; D019299:Decompression, Surgical / Q000379:methods*; D003714:Denervation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000601:surgery*; D010147:Pain Measurement; D011446:Prospective Studies; D016896:Treatment Outcome; D014276:Trigeminal Nerve / Q000601:surgery*
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