Not many people relish the thought of having surgery. As a migraine sufferer, you’ve probably heard about supraorbital nerve decompression and wondered what’s it all about – how big an operation is it, and what are the side effects and the success rate?
As it is still a relatively new procedure, supra
orbital nerve decompression should be considered an alternative treatment rather than a sure fire cure. While most patients experience relief and a reduction in the severity of headache pain, not everyone reports a complete cure from migraines. Migraine pain is very specific, and most sufferers are able to distinguish between a migraine and a normal headache that can be treated with over-the-counter medications. A reported absence of migraine following supraorbital nerve decompression does not necessarily mean the patient has no headache, only that they have no migraine.
Success rates following the procedure are not necessarily representative of a complete elimination of pain, but rather, are inclusive of those who experienced a 50% reduction in frequency, intensity and duration of their headaches.
However, in patients who suffer from severe migraines, reducing the pain by half would be a huge step in the right direction.
A Bit of Background to the Procedure
The discovery that decompression of the supraorbital nerve could relieve migraines was largely a happy accident. Decompression is a common side effect of Botox treatments to lift the brow, and when migraine sufferers repeatedly reported an improvement in their pain levels following Botox, the connection was eventually made.
Who is Suitable for Supraorbital Nerve Decompression Surgery?
Migraine surgery isn’t a viable option for every sufferer, and several assessment tests are done to determine patients' suitability on an individual basis. Some of requirements for consideration include:
- Migraine diagnosis by a neurologist
- Those with identifiable sites of nerve decompression
- How effective (or not) other treatments have been
- What medication side effects the patient experiences
- The severity, duration and frequency of migraines
- Good response to Botox or injections of local anesthesia
What Does the Procedure Involve?
It’s important to understand that supraorbital nerve decompression is not surgery on the brain. The skull bones are not penetrated or removed. The nerves in question are located beneath the skin in the brow region.
When the nerve is compressed, the resulting pressure causes pain and can lead to migraines. During surgery to relieve this pressure, small incisions are made through which the surgeon can remove blood vessels, tissue or muscle. This provides enough space for the nerve to function normally, which in turn relieves the pain that was caused when the nerve was compressed.
The surgical procedure is generally performed on an outpatient basis, and normally takes no longer than a couple of hours under general anesthetic. Small incisions in the brow area allow surgeons to remove the tissue that’s causing the compression, and afterwards these are closed with dissolving sutures and / or surgical glue.
Side Effects and Scarring
As surgical procedures go, supraorbital nerve decompression is relatively non-invasive, so any side effects or complications are minor and short-lived.
It’s normal to expect some bruising, swelling and tenderness in the affected sites, and some patients report headaches following surgery. As the effects of anesthetic wear off and the body repairs itself, these side effects diminish. The incisions are small, just a few centimeters, and are well hidden. After complete healing, there should be no outward sign that any surgery has taken place.
Most patients experience recovery periods of just a couple of weeks, during which the small wounds heal and any bruising or swelling subsides. During this time, common over-the-counter pain medications are usually sufficient to deal with any discomfort you might experience. Within a couple of weeks, patients can expect to return to normal activities.
Are There Complications?
Most people don’t experience any complications from undergoing this procedure, but as with any surgery, there are a few minor risks.
These include wounds that don’t heal as fast as they should, some unexpected bleeding, and very occasionally damage to nerves. There is also the risk that the surgery won’t completely cure your migraines, although as previously mentioned, the majority of patients are either cured or see a big reduction in the severity and how often they get headaches.
Would Supraorbital Nerve Decompression Suit You?
The first step is to speak with your neurologist, who could more fully explain the procedure and how it would affect you as an individual. As the procedure is relatively new for migraine relief, it may be something that you and your neurologist could look into together.