Corrugator supercilii muscle resection and migraine headaches

This study was conducted to determine whether there is an association betwe en the removal of the corrugator supercilii muscle and the elimination or s ignificant improvement of migraine headaches. Questionnaires were sent to 3 14 consecutive patients who had undergone corrugator supercilii muscle rese ction during endoscopic, transpalpebral, or open forehead rejuvenation proc edures. The patients were queried as to whether they had a history of migra ine headaches and, if so, whether the headaches significantly improved or d isappeared after surgery. If the answer was affirmative, then the patients were further questioned about the duration of the improvement or cessation of the headaches and the relationship to the timing of the surgery. After a n initial evaluation of the completed questionnaires, a telephone interview was conducted to confirm the initial answers and to obtain further informa tion necessary to ensure that the patients had a proper diagnosis based on the International Headache Society criteria for migraine headaches. The cha rts of the patients who had migraine headaches were studied to ascertain an d classify the type of surgery they had undergone. Patient demographics wer e reviewed, and the results were statistically analyzed. Of the 314 patients, 265 (84.4 pet-cent) either responded to the questionna ire, were interviewed, or both responded to the questionnaire and were inte rviewed. Of this group, 16 patients were excluded because of the provision of insufficient information to meet the International Headache Society crit eria, the presence of organic problems, and other exclusions mandated by st udy design. Thirty-nine (15.7 percent) of the remaining 249 patients had mi graine headaches that fulfilled the Society criteria. Thirty-one of the 39 (79.5 percent) with preoperative migraine noted elimination or improvement in migraine headaches immediately after surgery (p < 0.0001; McNemar), and the benefits lasted over a mean follow-up period of 47 months. When the res pondents with a positive history of migraine headaches were further divided , 16 patients (p < 0.0001; McNemar) noticed improvement over a mean follow- up period of 47 months, and 15 (p < 0.0001; McNemar) experienced total elim ination of their migraine headaches over a mean follow-up period of 46.5 mo nths. When divided by migraine headache type, 29 patients (74 percent) had nonaura migraine headaches. Of these patients, the headaches disappeared in 11 patients, improved in 13 patients, and did not change in five patients (p < 0.0001). Ten patients experienced aura-type headaches, which disappear ed or improved in seven of the patients and did not change in three of the patients (p < 0.0001). This study proves for the first time that there is i ndeed a strong correlation between the removal of the corrugator supercilii muscle and the elimination or significant improvement of migraine headache s.