Temporal Migraine Surgery: Relevance of Local Blood Vessels in Surgical Technique

Background: A surgical approach to migraine therapy is increasingly being considered and practiced, with reported success rates approaching 90%. Among the trigger sites addressed with this method, the temporal region is undoubtedly one of the most frequently involved. Methods: In this study, we describe our surgical approach for the treatment of temporally localized migraine. This technique involves neurolysis of the auriculotemporal nerve (which is never transected) and coagulation of all superficial temporal arterial and venous branches, which are often dilated or ectatic. Results: We interviewed 25 patients (22 females, 3 males; ages: [to be specified]) by telephone, all of whom had undergone surgery for migraine at temporal trigger sites. At the 12-month follow-up, the patient-reported resolution of pain averaged 88% (range: 25-100%). Only transient, minor complications (hypoesthesia, local itching) were reported. Conclusion: Based on our experience, this approach is supported by the common morphological findings observed and the distinctive symptomatology of this patient population. Fro m a clinical po int o f view, in our experience, the technique described has allowed us to obtain very satisfactory results, with a resolution of the symptoms close to 90% o f cases.