Targeting Headaches: Trigger release surgery an option for patients with chronic migraine

Dry nose and rhinorrhea have been reported in patients who underwent nasal surgery (Plast Reconstr Surg. 2005;115(1):1-9). Empty nose syndrome is a possible complication of turbinate removal, but “that’s not always done in every procedure,” Dr. Stepnick said. “Extensive, aggressive removal of the turbinates is not necessarily what’s being done in migraine surgery.”

Additional studies are needed to determine the long-term effects of surgical decompression, Dr. Lawrence said.

Further Considerations

Otolaryngologists interested in performing migraine surgery will “have to dedicate the time, the energy and the effort,” Dr. Janis said. “This is not something that can really be done on the side. You’re going to have to invest in some capital equipment because this does require surgical instrumentation, some of it endoscopic, and you’re going to have to learn the techniques.”

Case Western Reserve University School of Medicine offers an Annual Symposium for the Surgical Treatment of Migraine Headaches that includes lectures, live surgery and cadaver dissection; this year’s symposium will be held Oct. 22 and 23. The American Society of Plastic Surgeons occasionally offers courses as well.

Dr. Guyuron is optimistic about the future of migraine surgery and the involvement of otolaryngologists. “I think there is an enormous role for ENT colleagues,” he said. “There are 30.5 million Americans suffering migraine headaches. Even if we serve just 10 percent of that population, that’s 3.5 million Americans.”