Decompression Endoscopic Surgery for Frontal Secondary Headache Attributed to Supraorbital and Supratrochlear Nerve Entrapment: The Utrecht Experience

  • Boris FilipovićEmail author
  • J. Alexander de Ru
  • Peter J. F. M. Lohuis


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.


Secondary headache Migraine Nerve entrapment Decompression endoscopic surgery Migraine surgery Botulinum toxin type A 


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Boris Filipović
    • 1
    • 2
    • 3
    • 4
    Email author
  • J. Alexander de Ru
    • 5
  • Peter J. F. M. Lohuis
    • 2
    • 4
  1. 1.Department of Otorhinolaryngology/Head and Neck SurgeryUniversity Hospital Sveti DuhZagrebCroatia
  2. 2.Department of Otorhinolaryngology/Head and Neck SurgeryCenter for Facial Plastic and Reconstructive Surgery, Diakonessen HospitalUtrechtThe Netherlands
  3. 3.Department of Pharmacology, Laboratory of Molecular NeuropharmacologyUniversity of Zagreb School of MedicineZagrebCroatia
  4. 4.Poliklinika Lohuis Filipović Medical Group d.o.o., Private ClinicZagrebCroatia
  5. 5.Department of Otorhinolaryngology/Head and Neck SurgeryCentral Military HospitalUtrechtThe Netherlands

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