Abstract:

Objective

To investigate the effect of radical nerve resection on intractable auriculotemporal migraine.

Methods

The clinical data of 32 patients with intractable auriculotemporal neurogenic migraine who underwent radical auriculotemporal neuroresection treatment in the Department of Neurosurgery of China-Japan Friendship Hospital from January 2022 to January 2023 were retrospectively analyzed. All patients were followed up for 2 years after surgery. Pre- and postoperative comparisons were made regarding pain relief， numbness status， overall surgical satisfaction， as well as symptom recurrence and outcomes.

Results

（1） Pain score： The numerical rating scale （NRS） score immediately after surgery was 0.5 （0， 2）， which was significantly lower than the preoperative NRS score of 8 （8， 9）， and the difference was statistically significant （P＜0.05）； After 2 years of follow-up， the NRS score was 0 （0， 1） points. （2） Numbness score： The visual analogue scale （VAS） score of 6 （5， 7） immediately after surgery was significantly higher than that of 0 （0， 0） before surgery， and the difference was statistically significant （P＜0.05）； After 2 years of follow-up， the VAS score was 3 （2， 3.75）. （3） Overall satisfaction： The postoperative satisfaction rate was 34.38% （11/32）， and after 3 months， the surgical satisfaction rate increased to 84.38% （27/32）. After 2 years of follow-up， the surgical satisfaction rate was 93.75% （30/32）. （4） There was one recurrence 1 year after operation， which was the formation of a small neuroma at the nerve stump. After the second operation， the symptoms were relieved.

Conclusions

Radical neurotomy is an effective method for the treatment of intractable auriculotemporal neurogenic migraine.

Key words: Migraine, Auriculotemporal nerve, Radical surgery, Neurectomy