MIGRAINE SURGERY: COMPARATIVE ANALYSIS OF TWO SURGICAL TECHNIQUES FOR THE TREATMENT OF TEMPORAL MIGRAINE: NEURECTOMY AND DECOMPRESSION OF THE ZYGOMATICOTEMPORAL NERVE BRANCH

Abstract

Migraine is one of the most common neurological disorders, significantly reducing patients’ quality of life and leading to considerable socioeconomic burden. For patients resistant to pharmacological therapy, surgical treatment aimed at deactivating trigger sites represents an alternative option. This prospective randomized study compared two surgical techniques for temporal migraine: decompression and neurectomy of the n.zygomaticotemporalis. The study included 20 patients with bilateral temporal migraine; each patient underwent both procedures — decompression on one side and neurectomy on the other. Effectiveness was assessed by the frequency, intensity, and duration of migraine attacks, as well as by the Migraine Headache Index and MIDAS scale, during a 12-month follow-up period. Results demonstrated high efficacy of both approaches: significant improvement (>50%) was observed in 89% of surgical sites, while complete elimination of symptoms was achieved in 60%. No statistically significant difference was found between the two methods. In conclusion, avulsion and decompression of the n.zygomaticotemporalis are safe and comparably effective surgical methods for the treatment of temporal migraine. Decompression may be considered the first-line surgical approach, while neurectomy serves as a reserve option in cases of insufficient decompression outcomes.