WORLD JOURNAL OF PLASTIC SURGERY
Mon, Jul 13, 2026
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Fatemeh Samiei *1 
, Hojjat Molaei2 , Mansoureh Togha3 , Hamidreza Fathi2 , Ali Yavari2 , Changiz Delavari2 , Abbas Tafakhori4
, Hojjat Molaei2 , Mansoureh Togha3 , Hamidreza Fathi2 , Ali Yavari2 , Changiz Delavari2 , Abbas Tafakhori4
1- Department of Plastic & Reconstructive Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2- Department of Plastic & Reconstructive Surgery, Tehran University of Medical Sciences, Tehran, Iran
3- Headach Department, Iranian Center of Neurological Research, Sina Hospital , Tehran University of Medical Sciences, Tehran, Iran.
4- Iranian Center of Neurological Research (ICNR), Neuroscience Institute, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
2- Department of Plastic & Reconstructive Surgery, Tehran University of Medical Sciences, Tehran, Iran
3- Headach Department, Iranian Center of Neurological Research, Sina Hospital , Tehran University of Medical Sciences, Tehran, Iran.
4- Iranian Center of Neurological Research (ICNR), Neuroscience Institute, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
Abstract: (7 Views)
Background: Migraine is a chronic and debilitating disease that, despite therapeutic advances, many patients do not respond to conventional treatments. Surgeries such as neurolysis and neurectomy of the greater occipital nerve (GON) have been proposed as surgical options for treating these patients. We aimed to compare the effectiveness of these two methods in reducing symptoms of chronic treatment-resistant migraine.
Methods: This study was conducted as a randomized, prospective clinical trial. Ten patients with chronic treatment-resistant migraine were divided into neurolysis and neurectomy groups. Primary and secondary outcomes including pain intensity using the Visual Analog Scale (VAS), migraine-related disability using the Migraine Disability Assessment (MIDAS) questionnaire, and headache impact on quality of life using the Headache Impact Test (HIT-6) questionnaire were evaluated at intervals of one month, three months, and six months after surgery.
Results: No significant difference was observed between the neurolysis and neurectomy groups in HIT-6, MIDAS scores, and pain intensity (VAS) at any of the measurement times (P-value>0.05). Also, using the Friedman test, no significant difference was observed between the three measurement stages in either group (P-value>0.05). For both pain intensity (VAS) and MIDAS variables, the changes observed over time were not significant, and there was no significant difference between the two groups at any time point.
Conclusion: Both neurolysis and neurectomy methods might be considered as effective treatment options for patients with chronic treatment-resistant migraine. Personalized treatment and team decision-making are helpful in selecting the appropriate surgical method for patients with chronic migraine.
Methods: This study was conducted as a randomized, prospective clinical trial. Ten patients with chronic treatment-resistant migraine were divided into neurolysis and neurectomy groups. Primary and secondary outcomes including pain intensity using the Visual Analog Scale (VAS), migraine-related disability using the Migraine Disability Assessment (MIDAS) questionnaire, and headache impact on quality of life using the Headache Impact Test (HIT-6) questionnaire were evaluated at intervals of one month, three months, and six months after surgery.
Results: No significant difference was observed between the neurolysis and neurectomy groups in HIT-6, MIDAS scores, and pain intensity (VAS) at any of the measurement times (P-value>0.05). Also, using the Friedman test, no significant difference was observed between the three measurement stages in either group (P-value>0.05). For both pain intensity (VAS) and MIDAS variables, the changes observed over time were not significant, and there was no significant difference between the two groups at any time point.
Conclusion: Both neurolysis and neurectomy methods might be considered as effective treatment options for patients with chronic treatment-resistant migraine. Personalized treatment and team decision-making are helpful in selecting the appropriate surgical method for patients with chronic migraine.
Type of Study: Original Article |
Subject:
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