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Migraine Surgery Slow to Catch on Among Plastic Surgeons

A simple plastic surgery procedure can help some patients with migraine headaches.

But so far, relatively few U.S. plastic surgeons are performing migraine surgery, reports a study in the March issue of Plastic and Reconstructive Surgery, the official medical journal of the American Society of Plastic Surgeons.

Plastic surgeons are aware of studies showing the effectiveness of migraine surgery, and at least some are interested in performing the procedure. However, they still perceive "significant barriers" to the increased use of surgical treatment for migraine, according to the study by Dr. Theodore A. Kung and colleagues of University of Michigan, Ann Arbor.

Research About Migraine Surgery

The researchers surveyed nearly 3,500 ASPS members regarding their knowledge, attitudes and experience related to migraine surgery.

Recent studies have shown good results with a simple surgical procedure for migraine patients who don't respond to initial treatments. The surgical techniques were developed by plastic surgeons who noticed that some migraine patients had fewer headaches after undergoing cosmetic forehead-lift procedures.

Questionnaire responses from nearly 200 plastic surgeons were analyzed. Of these, just 18 percent had performed surgery for the treatment of migraine. Of those who did, more than 80 percent said the surgery improved the patients' migraine symptoms.

Most plastic surgeons were at least "somewhat familiar" with studies reporting on the effectiveness of migraine surgery. Sixty percent said they would be interested in offering migraine surgery if an appropriate patient were referred to them by a board certified neurologist.

Many of the surgeons surveyed felt they weren't familiar enough with the technique of migraine surgery-or with migraine in general-to perform the procedure. Most were unaware that migraine surgery is covered by some major health insurers, including Medicare.

Barriers to Wider Acceptance of the Treatment

Migraine is a common problem that interferes with many aspects of daily life for millions of Americans. New surgical techniques have the potential to reduce or eliminate migraine attacks for many patients who do not respond to medications or other current treatments.

Previous studies have reported good results one to five years following migraine surgery. The study has some important limitations-especially the very low survey response rate (about five percent). However, the results suggest that at least some U.S. plastic surgeons are performing migraine surgery and achieving good results for their patients.

Many others are aware of research showing the effectiveness of migraine surgery, and would be willing to perform it if perceived obstacles to the procedure could be overcome.

"Increased referral of suitable patients by neurologists and improved familiarity with the concept and techniques of migraine surgery may motivate more plastic surgeons to perform migraine surgery," Dr. Kung and coauthors write. They also call for "appropriately designed clinical trials" to confirm the benefits of migraine surgery.
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