In a placebo-controlled study, funded by the American Society of Plastic Surgeons (ASPS) National Endowment for Plastic Surgery, plastic surgeons found that 90% of severe migraine sufferers reported complete elimination or significant decrease in the frequency and intensity of headaches following surgical treatment.

“Roughly 10% of the population suffers from severe migraine headaches—until now there has been no treatment to completely eliminate them,” says Bahman Guyuron, MD, the study author and chief of the Division of Plastic Surgery at Case Western Reserve University in Cleveland. “This is a randomized, placebo-controlled study, which provides the strongest scientific evidence that this treatment is safe and effective. We are now ready to train physicians across the country so this can become standard practice.”

In the study, 76 patients suffering from severe migraines were examined by plastic surgeons and neurologists. Patients were given botulinum toxin Type A injections to determine which muscles in the forehead, temple, or back of the neck triggered their migraines and to assess their potential response to surgery. Those who reported improvement after the injections were selected for the study.

Patients were randomly selected for surgical treatment or the placebo group. Surgical treatment involved removing portions of muscle or a minor nerve, helping to relive nerve compression and  inflammation.

Fifty patients had surgical treatment for their migraines, and 26 patients were selected for the placebo-controlled surgery group.

The results of the study found that migraine sufferers who were treated surgically experienced a statistically significant decrease in frequency and intensity of migraine headaches as compared to the placebo group. One year after surgery, 90% of the surgically treated patients reported a complete elimination or significant decrease in headaches.

“Elements of this procedure involve modifications of plastic surgery techniques traditionally used to minimize facial wrinkles,” says Guyuron. “In fact, this research began when several of my patients mentioned that their headaches had disappeared after forehead rejuvenation.”

According to Roxanne Guy, MD, ASPS president, surgical treatment for migraines should be reserved for those who suffer from severe migraines—at least two to three headaches per month—and those who do not respond to or can not take medication. Guy notes that this treatment is not intended for patients who can be relieved of pain with a high dose of acetaminophen.

[www.sootoday.com, October 27, 2006]