COMPARATIVE EFFECTIVENESS OF ENDOSCOPIC DECOMPRESSION OF THE GREATER OCCIPITAL NERVE AND TRADITIONAL SURGICAL METHODS IN THE TREATMENT OF CHRONIC MIGRAINE
Keywords:
chronic migraine, greater occipital nerve, nerve decompression, endoscopic surgery, migraine surgery.Abstract
Background. Chronic migraine is one of the most common forms of primary headache and significantly reduces patients’ quality of life. In recent years, surgical treatment of migraine has been actively developed, focusing on the elimination of peripheral trigger zones and decompression of sensory nerves. Compression of the greater occipital nerve is considered one of the key pathogenetic factors in occipital forms of chronic migraine.
Objective. To evaluate the effectiveness of endoscopic decompression of the greater occipital nerve and compare its outcomes with traditional surgical techniques for the treatment of chronic migraine.
Materials and Methods. The study included 293 patients with chronic migraine who underwent surgical treatment between 2020 and 2025. The control group consisted of 145 patients treated with conventional surgical methods. The main group included 148 patients who underwent endoscopic decompression of the greater occipital nerve.
Results. The use of endoscopic techniques reduced the incidence of postoperative sensory complications and improved the stability of clinical outcomes. Favorable clinical results were observed in 70% of patients in the control group and in 85% of patients in the main group.
Conclusion. Endoscopic decompression of the greater occipital nerve is an effective and safe surgical method for the treatment of chronic migraine and represents a promising direction in migraine surgery.
References
Guyuron B., Reed D., Kriegler J. Surgical treatment of migraine headaches. Plastic and Reconstructive Surgery. 2009.
Janis J., Hatef D. Neurovascular compression of the greater occipital nerve. Plastic and Reconstructive Surgery. 2010.
Ducic I., Felder J., Fantus S. A systematic review of peripheral nerve interventional treatments for chronic headaches. Annals of Plastic Surgery. 2014.
Guyuron B., Kriegler J., Davis J. Comprehensive surgical treatment of migraine headaches. Plastic and Reconstructive Surgery. 2005.
Peled Z., Guyuron B. Migraine surgery: current perspectives. Plastic and Reconstructive Surgery. 2017.
Ducic I., Hartmann E., Larson E. Indications for surgical treatment of migraine headaches. Plastic and Reconstructive Surgery. 2009.
Janis J., Dhanik A., Howard J. Validation of the peripheral trigger point theory of migraine headaches. Plastic and Reconstructive Surgery. 2011.
Gfrerer L., Hansdorfer M., Ortiz R. Surgical treatment of occipital neuralgia and migraine. Journal of Neurosurgery. 2019.
Chim H., Schierle C. Occipital nerve decompression for migraine headaches. Annals of Plastic Surgery. 2013.
Ducic I., Taylor N., Dellon A. Relationship between migraine headache and occipital nerve compression. Microsurgery. 2009.
Guyuron B. Surgical treatment of migraine headaches. The Lancet Neurology. 2012.
Nagori S., Jose A. Peripheral nerve surgery for migraine. Journal of Craniofacial Surgery. 2018.
Shauly O., Gould D., Patel K. Greater occipital nerve decompression for chronic migraine. Aesthetic Surgery Journal. 2019.
Ducic I., Moriarty M., Al-Attar A. Anatomical variations of the greater occipital nerve. Plastic and Reconstructive Surgery. 2009.
Dash K., Janis J. Trigger site surgery for migraine headaches. Seminars in Plastic Surgery. 2018.
Olla D., et al. Surgical approaches for greater occipital nerve decompression. BMC Surgery. 2022.
Tabeeva G.R. Хроническая мигрень: современные подходы к лечению. Неврология. 2018.
Isagulyan E.D., Tomsky A.A. Нейромодуляция в лечении хронической боли. Клиническая и экспериментальная хирургия. 2016.
Casale R., Atzeni F. Pain in women: a perspective review. Pain and Therapy. 2021.
Chang I., Wells M. Nonpharmacologic treatments for chronic migraine. Plastic and Reconstructive Surgery. 2023.
