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Decompression endoscopic surgery for frontal secondary headache attributed to supraorbital and supratrochlear nerve entrapment: a comprehensive review

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Abstract

In the last decade, a new surgical treatment modality was developed for frontal secondary headache, based on the assumption that the trigger of this pain entity is the entrapment of peripheral sensory nerves. The surgery entails a procedure, where an endoscopic approach is used to decompress the supraorbital and supratrochlear nerve branches, which are entrapped by the periosteum in the region of the corrugator supercilii muscle. Candidates for the surgery define their headache as moderate to severe persistent daily pressure or tension, localized in the frontal area, sometimes accompanied by symptoms of nausea and photophobia mimicking a primary headache—migraine. We created a step-by-step screening algorithm which is used to differentiate patients that have the highest chance for a successful surgical decompression. Up to now, published data regarding this type of surgery demonstrate long-lasting successful outcomes while adverse effects are minor. This article reviews and discusses from a surgeon’s perspective decompression surgery for secondary headache attributed to supraorbital and supratrochlear nerve entrapment.

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Acknowledgements

We are thankful to Mr. Nikola Šudelija and Mr. Ivan Filipović for graphic design and illustration contribution.

Author information

Authors and Affiliations

  1. Department of Otorhinolaryngology/Head and Neck Surgery, University Hospital Sveti Duh, Sveti Duh 64, 10000, Zagreb, Croatia

    Boris Filipović

  2. Department of Otorhinolaryngology/Head and Neck Surgery, Center for Facial Plastic and Reconstructive Surgery, Diakonessen Hospital, Utrecht, The Netherlands

    Boris Filipović, Rick van de Langenberg, Pepijn A. Borggreven & Peter J. F. M. Lohuis

  3. Department of Pharmacology, Laboratory of Molecular Neuropharmacology, University of Zagreb School of Medicine, Zagreb, Croatia

    Boris Filipović & Zdravko Lacković

  4. Department of Otorhinolaryngology/Head and Neck Surgery, Central Military Hospital, Utrecht, The Netherlands

    J. Alexander de Ru

Authors
  1. Boris Filipović
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  2. J. Alexander de Ru
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  3. Rick van de Langenberg
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  4. Pepijn A. Borggreven
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  5. Zdravko Lacković
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  6. Peter J. F. M. Lohuis
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Corresponding author

Correspondence to Boris Filipović.

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Funding

This is a non-funded study.

Ethical approval

All procedures performed in study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Conflict of interest

The authors declare that they have no conflict of interest.

Electronic supplementary material

Below is the link to the electronic supplementary material.

405_2017_4450_MOESM1_ESM.wmv

Online Resource 1. Decompression surgery for frontal secondary headache; endoscopic approach. Video shows endoscopic elevation of the forehead skin–muscle–periosteum flap in a subperiosteal plane. Incision of the periosteum is made at the supraorbital rims, followed by blunt dissection of the glabellar muscles, until both supraorbital and supratrochlear nerve with accompanying vessels are well visualized. (WMV 11865 KB)

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Filipović, B., de Ru, J.A., van de Langenberg, R. et al. Decompression endoscopic surgery for frontal secondary headache attributed to supraorbital and supratrochlear nerve entrapment: a comprehensive review. Eur Arch Otorhinolaryngol 274, 2093–2106 (2017). https://doi.org/10.1007/s00405-017-4450-x

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  • DOI: https://doi.org/10.1007/s00405-017-4450-x

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