Decompression Endoscopic Surgery for Frontal Secondary Headache Attributed to Supraorbital and Supratrochlear Nerve Entrapment: The Utrecht Experience
In the last decade, a new surgical treatment modality was developed for frontal secondary headache, based on the assumption that the trigger of this pain entity is the entrapment of peripheral sensory nerves. The surgery entails a procedure, where an endoscopic approach is used to decompress the supraorbital and supratrochlear nerve branches, which are entrapped by the periosteum in the region of the corrugator supercilii muscle. Candidates for the surgery define their headache as moderate to severe persistent daily pressure or tension, localized in the frontal area, sometimes accompanied by symptoms of nausea and photophobia mimicking a primary headache—migraine. We created a step-by-step screening algorithm which is used to differentiate patients that have the highest chance for a successful surgical decompression. Up to now, published data regarding this type of surgery demonstrate long-lasting successful outcomes, while adverse effects are minor.
KeywordsSecondary headache Migraine Nerve entrapment Decompression endoscopic surgery Migraine surgery Botulinum toxin type A
- 1.World Health Organization. Headache disorders. 2012. http://www.who.int/mediacentre/factsheets/fs277/en/. Accessed 11 Sept 2016.
- 12.Filipović B, de Ru JA, van de Langenberg R, Borggreven PA, Lacković Z, Lohuis PJFM. Decompression endoscopic surgery for frontal secondary headache attributed to supraorbital and supratrochlear nerve entrapment: a comprehensive review. Eur Arch Otorhinolaryngol. 2017;274:2093–106. https://doi.org/10.1007/s00405-017-4450-x.CrossRefPubMedGoogle Scholar
- 28.Olesen J, Peer Tfelt-Hansen K, Welch A, Goadsby PJ, Ramadan NM. The headaches third edition. Philadelphia: Lippincott Williams and Wilkins; 2006.Google Scholar
- 30.Filipovic B, de Ru JA, Hakim S, van de Langenberg R, Borggreven PA, Lohuis PJFM. Treatment of frontal secondary headache attributed to Supratrochlear and supraorbital nerve entrapment with Oral medication or Botulinum toxin type a vs endoscopic decompression surgery. JAMA Facial Plast Surg. 2018 Sep 1;20(5):394–400. https://doi.org/10.1001/jamafacial.2018.0268.CrossRefPubMedPubMedCentralGoogle Scholar
- 31.Omranifard M, Abdali H, Ardakani MR, Talebianfar M. a comparison of outcome of medical and surgical treatment of migraine headache: in 1 year follow-up. Adv Biomed Res. 2016;29(5):121.Google Scholar