Filipović Boris, de Ru J Alexander, van de Langenberg Rick, Borggreven Pepijn A, Lacković Zdravko, Lohuis Peter J F M
Department of Otorhinolaryngology/Head and Neck Surgery, University Hospital Sveti Duh, Sveti Duh 64, 10000, Zagreb, Croatia.
Department of Otorhinolaryngology/Head and Neck Surgery, Center for Facial Plastic and Reconstructive Surgery, Diakonessen Hospital, Utrecht, The Netherlands.
Eur Arch Otorhinolaryngol. 2017 May;274(5):2093-2106. doi: 10.1007/s00405-017-4450-x. Epub 2017 Jan 25.
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.
在过去十年中，基于外周感觉神经受压是这种疼痛病症触发因素的假设，一种针对额部继发性头痛的新手术治疗方式得以开发。该手术需要进行一个操作，即采用内镜入路对眶上神经和滑车上神经分支进行减压，这些神经分支在皱眉肌区域被骨膜卡压。该手术的候选患者将他们的头痛定义为中度至重度的持续性每日压迫感或紧张感，局限于额部区域，有时伴有恶心和畏光症状，类似原发性头痛——偏头痛。我们创建了一个逐步筛选算法，用于区分手术减压成功几率最高的患者。到目前为止，关于这类手术的已发表数据显示出长期的成功结果，而不良反应较小。本文从外科医生的角度回顾并讨论了因眶上神经和滑车上神经受压导致的继发性头痛的减压手术。
