Outcome Comparison of Endoscopic and Transpalperbral Decompression for Treatments of Frontal Migraine Headaches

Background: This study was designed to compare the efficacy of the transpalpebral versus endoscopic approach to decompression of the supraorbital and supratrochlear nerves in patients with frontal migraine headaches.

Methods: The medical charts of 253 patients who underwent surgery for frontal migraine headaches were reviewed. These patients either underwent transpalpebral nerve decompression (TPND, n=62) or endoscopic nerve decompression (END, n=191). The preoperative and >12 month postoperative migraine frequency, duration, and intensity were analyzed to determine the success of the surgeries.

Results: Forty-nine (79%) of 62 patients in the TPND group and 170 (89%) of 191 patients who underwent END experienced a successful outcome (at least 50% decrease in migraine frequency, duration, or intensity) after one year from surgery. END had a significantly higher success rate than TPND (p<0.05). Thirty-two (52%) patients in the TPND group and 128 (67%) patients who underwent END observed elimination of migraine headaches. The elimination rate was significantly higher in the END group than in the TPND group (p<0.03).

Conclusions: END was found to be more successful at reducing or eliminating frontal migraine headaches than TPND and should be selected as the first choice whenever it is anatomically feasible.