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Endoscopic surgery for headaches and migraines

The team of the Lohuis Filipović Polyclinic is the first in Croatia and the region to perform this procedure – MIGRAINE SURGERY

The team of the Lohuis Filipović Polyclinic is the first in Croatia and the region to perform this procedure – MIGRAINE SURGERY

For the last 10 years, our top medical team led by dr.sc. Peter JFM Lohuis and doc. dr.sc. Boris Filipović developed and applies a new, minimally invasive surgical procedure for severe headaches, such as migraine.

For the last 10 years , our top medical team, led by dr.sc. Peter JFM Lohoquis and doc. dr.sc. Boris Filipović has developed and applied a new, minimally invasive surgical procedure for severe headaches, such as migraine.

About 15 years ago in the United States, it was discovered quite by accident that a procedure in plastic surgery, called endoscopic eyebrow lift, can reduce severe pain in chronic migraine.

Our team participated in the writing of a professional book on this topic: Atlas of Surgical Therapy for Migraine and Tension-Type headache, which was published in 2020.

Surgical treatment of headaches is based on reducing the pressure of sensory nerves by endoscopic means, popularly called migraine surgery. Endoscopic surgery means minimal invasiveness and a quick recovery for the patient.

Benefits of Migraine Surgery:

  • 70 to 95% of patients report a reduction or complete disappearance of headaches after the procedure
  • quick result – patients, as a rule, immediately feel a reduction in pain
  • Safe procedure with minimal invasiveness
  • Quick recovery and return to daily activities

Migraine is a complex neurological disease whose main symptom is headache, which can be moderate to severe intensity. According to research, 12 to 15% of adults suffer from migraines. Women are more likely to suffer from migraines than men, in a ratio of 3:1.

Migraine sufferers experience a distinct throbbing pain or throbbing sensation, usually only on one side of the head. The pain can last for hours or days and be so severe that it prevents normal functioning and activity.

In addition to headaches, there are also accompanying symptoms such as dizziness, nausea, general weakness, sensitivity to light and noise, and other symptoms.

Treatment of a complex disease such as migraine requires a multidisciplinary team of experts for the purpose of proper diagnosis, and then a multimodal approach to treatment. In our team we have a neurologist, an anesthesiologist, an otorhinolaryngologist and a head and neck surgeon and a dentist.

The most common types of headaches that the expert team of the Headache Center treats are migraines, headaches caused by nerve compression, sinus and chronic daily headaches.

Everything You Need to Know About Migraine Surgery

Some patients who suffer from headaches tend to have the nerves in their head and neck more sensitive to the pressure of structures that are located near them, such as muscles, ligaments and blood vessels. For this reason, migraine surgery is based on decompression, that is, the release of nerves.

Surgical nerve decompression in the treatment of headache involves releasing branches of peripheral sensory nerves in 4 different areas of the head and neck that are believed to be trigger points for migraines and other types of headaches:

  • forehead (frontal area) – we perform decompression of the supraorbital (SON) and supratrochlear nerves (STN)
  • temporal area – decompression of the auriculotemporal nerve (ATN)
  • middle part of the face – decompression of the zygomatic-facial nerve (ZFN)
  • Occipital nerve decompression (GON)

The location of the procedure depends on the area in which the headache occurs and which the patient himself points to. Migraine headache most often occurs unilaterally, i.e. only on one side of the head, mostly in the area of the forehead, temples and back of the head.

Migraine has long been associated with pressure (compression) and irritation of the main peripheral nerves of the head and neck caused by surrounding structures (muscles, ligaments, etc.). In the case of severe headaches, these nerves are also genetically more susceptible to the reaction to pressure.

By relieving the pressure of the pinched nerves surgically, it is possible to reduce the frequency, severity and duration of headaches, or completely eliminate them.

Our recently published, previously mentioned research on the effectiveness of migraine surgery, as well as other studies published in the last 10 years, can confirm that with properly set indications, surgery is the most effective procedure that, compared to various drug therapies or injections, has almost no side effects.

The course of the procedure

Surgical treatment of headache is performed under general anesthesia. Before the operation itself, it is necessary to perform laboratory tests of blood and urine and consultation with an anesthesiologist.

If you suffer from an allergy to certain medications or use regular therapy for certain diseases, be sure to mention this during the conversation with the anesthesiologist to prevent the possible occurrence of side effects related to anesthesia.

On the day of the procedure, it is necessary to be on an empty stomach, it is not allowed to consume food and drinks from midnight of the previous day.

After the application of anesthesia, the surgical procedure is performed.

The surgeon makes small incisions in the skin at the previously selected site of the procedure. Through the incisions made, an endoscope – a thin tube with a mini camera is entered through the incision and precisely releases the pressed nerves (decompression).

The procedure takes an average of 1 hour.

The advantage of an endoscopic procedure is a quick return to daily activities with minimal discomfort. For this reason, surgical treatment of headaches is treated as an outpatient procedure in most cases.

In most cases, on the same day after migraine surgery , the patient goes to home care.

Recovery may be accompanied by slight or no pain and discomfort, and most patients can return to work in seven days. Some patients may have minor swelling that resolves on its own in the first few days of recovery.

Candidates for surgical treatment of headaches

Whether you are a good candidate for migraine surgery depends on the individual symptoms of migraine and the overall clinical picture. Before the procedure, it is definitely necessary to do an examination and consultation with our specialist doctors.

Generally speaking, you are a good candidate for surgical treatment if:

  • you have been diagnosed with chronic migraine or occipital neuralgia by a neurologist (not all headaches are migraines)
  • Treatment of migraine with conservative methods (behavioral therapy, medications) does not give results
  • you are not able to use pharmacotherapy (medication) due to the occurrence of side effects

In our experience, anti-headache surgery is also suitable for the most severe forms of headache that occur almost daily, and in which other methods are usually ineffective.

We recommend that you watch a video about the experience of our patients with migraine surgery before the procedure.

Risks and possible complications of surgical treatment of headache

Migraine surgery is performed endoscopically, so after the procedure, a return to daily activities is possible in a few days. It is an extremely safe procedure that largely passes without side effects and complications.

In most cases, the only side effect that patients feel is numbness at the site of surgery, which disappears on its own in a few days, up to several weeks after the procedure.

Thanks to the extensive experience and expertise of our surgeons, the likelihood of other complications occurring after surgery is minimal.

Most complications can be prevented by detailed communication with our professional staff and proper postoperative care.

You will discuss all the possible risks during and after surgical treatment of headaches with specialist doctors before agreeing to surgery.

It is important that you ask your surgeon questions about everything that worries you. In case of complications, it is important to react immediately and start treatment urgently.

Results of Surgical Treatment of Headache and What to Expect After Surgery

For migraine patients who do not respond well to other treatments, migraine surgery can be a solution that restores their quality of life. The goal of migraine surgery is to reduce headaches.

Migraines have long been associated with compression and irritation of key nerves in your face and head. These triggers can be chronic, they can have genetic causes, or they can be the result of changes that occur over time.

Surgical relief of pressure on compressed nerves can reduce the frequency, severity, and duration of headaches, or even eliminate them altogether.

Migraine surgery reduces irritation and compression of the trigger nerves, either by straightening the tissue surrounding the nerves or blocking pain signals.

After surgery, some patients may still have headaches, but may have a significant reduction in the frequency, duration, and/or severity of headaches.

According to recent research, a high percentage of patients after surgical treatment of headaches report significant advances in the form of reduction of pain and the occurrence of headaches.

According to one study, 88% of patients surveyed even 5 years after migraine surgery reported at least a 50% reduction in the frequency, severity, and duration of headaches.

The University of Wisconsin-Madison reports studies showing success rates of more than 70%, with about a third of patients reporting that their headaches have completely disappeared.

Make an appointment for an examination

At the Lohuis Filipović Polyclinic, we strive to find the right solution for the treatment of headaches, including migraines.

Whether it is drug therapy, injections or surgery, our goal is for you to leave the clinic without headaches and ready to perform everyday activities without unnecessary distractions.

Make an appointment today by calling +3851 2444 646 or filling out the online form.

What do our patients say about us?

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I did rhinoplasty along with face tight treatment and the results were more than satisfactory. The guys (Boris and Peter) did everything at the same time, very professionally and in the shortest possible timeframe. I was out of tampons in 2 days, and my bruise recovery does not take longer than 7 days. Very gentle […]

J.Lj.
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I had unwittingly been suffering from hypopnea for nearly a decade. I did some research and I selected this clinic because it was located in a country where I have many friends. I had already been treated for this by a different physician in Canada, a surgery was done in my nose to remove an […]

A.P.
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For so long I was dissatisfied with the breathing and the appearance of my nose. Of course the first step was to google rhinoplasty and read comments on forums of the people who did it in Croatia. That did not help because the amount of negative experiences only scared me. But I also read that […]

M.K.
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I’ve done plasma skin regeneration and skin boosting treatment there. Clinic is beautiful, stuff is very friendly, young and with great knowledge and experience. I would recommend it to anyone who is looking high quality in every aspect. Thank you!

M.G.
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A month ago, I was on a lip lift with Dr. Filipović. The result is fantastic, as was the experience of consultation and surgery. The doctor and nurses are professional and approachable and inspire confidence. The lip lift turned out great and looks natural, but it’s a big enough change that it affected the look […]

M.S.
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