Decompression–Avulsion of the Auriculotemporal Nerve for Treatment of Migraines and Chronic Headaches

Sanniec, Kyle; Borsting, Emily Ann; Amirlak, Bardia

doi:10.1097/gox.0000000000000663

Cited by 39 publications

(20 citation statements)

References 16 publications

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“…The main compression point is where the anterior superficial temporal artery crosses the distal branch of the nerve (site 5A). 35 The second most common tender area, in our experience, is above constricting fibrous bands on the AT nerve directly superior to the temporomandibular joint (site 5B). Point tenderness here should not be confused with temporomandibular joint pain, which requires a different treatment.…”

Section: Temporal Sitesmentioning

confidence: 63%

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Anatomical Regional Targeted (ART) BOTOX Injection Technique: A Novel Paradigm for Migraines and Chronic Headaches

Amirlak

Sanniec

Pezeshk

et al. 2016

Plastic and Reconstructive Surgery - Global Open

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Section: Temporal Sitesmentioning

confidence: 63%

“…As we described in a previous publication, 35 these areas can vary slightly and rely on point tenderness to target drug delivery more effectively.…”

Section: Temporal Sitesmentioning

confidence: 99%

Anatomical Regional Targeted (ART) BOTOX Injection Technique: A Novel Paradigm for Migraines and Chronic Headaches

Amirlak

Sanniec

Pezeshk

et al. 2016

Plastic and Reconstructive Surgery - Global Open

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“…The auriculotemporal nerve (AT) is addressed by decompression with a small 1 cm incision in the high temple over the compression site of the temporal artery, with or without traction avulsion of the nerve in the periauricular area and ligation of the temporal artery (Amirlak's approach) [38]. Similarly, low rates of temporary paresthesia and minor anesthesia have been reported, without reports of facial nerve injury.…”

Section: Temporal Triggersmentioning

confidence: 99%

Surgical Management of Migraine Headaches

Chung¹,

Sanniec²,

Li³

et al. 2017

Current Perspectives on Less-Known Aspects of Headache

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Although migraines are experienced by a significant portion of the population, current medical therapies often fail to completely alleviate the symptoms of many migraine sufferers, leading to significant residual disability. Within the last decade, migraine surgery has arisen as a viable option for patients who have exhausted all other medical treatments. Despite early resistance in the headache care community, it has become more accepted due to an increasing number of studies demonstrating efficacy and safety, and increasing evidence supporting the influence of peripheral nerves in the progression of migraine pathophysiology. Yet, it remains crucial to carefully select appropriate surgical candidates based on the assessment of various factors such as medication use, pain distribution, and any other medical conditions that may contribute to headache. It is equally important to ensure that the patient has a strong relationship with a neurologist for optimal medical management and postoperative medical support. After the appropriate trigger sites are identified, various techniques can be used to decompress the involved larger nerves, avulse the smaller nerves, and address any intranasal pathology that could be causing migraines.

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“…Site V refers to pain in the area corresponding to the auriculotemporal nerve (AT). Pain in this area is caused by TMJ facial bands inferiorly and the temporal artery more superiorly, causing irritation to the AT nerve [40]. Finally, Site VI refers to the area around the lesser occipital nerve.…”

Section: Trigger Sites and Peripheral Nerve Irritation Hypothesismentioning

confidence: 99%

Management of Migraine Headaches: OnabotulinumtoxinA Injection

Chung¹,

Li²,

Sanniec³

et al. 2017

Current Perspectives on Less-Known Aspects of Headache

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Chronic migraines are a common debilitating headache disorder. Recently, there has been increasing interest in the use of onabotulinumtoxinA as a preventative treatment, as studies have shown significant benefits. In line with current accepted theories on the pathophysiology of migraines, the toxin works by both direct and indirect means to prevent peripheral and central nerve sensitization. While efficacy has been established, the technique for extracranial delivery of onabotulinumtoxinA continues to see changes in an effort to seek better outcomes. The PREEMPT injection protocol is the original injection paradigm design targeting broad muscle groups. The ART injection paradigm offers the ability to deliver onabotulinumtoxinA closer to culprit nerves, thus increasing its effect and also decreasing adverse effects. OnabotulinumtoxinA is an effective and well-tolerated option for selective patients seeking relief from migraine headaches.

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Decompression–Avulsion of the Auriculotemporal Nerve for Treatment of Migraines and Chronic Headaches

Abstract: Supplemental Digital Content is available in the text.

Cited by 39 publications

References 16 publications

Anatomical Regional Targeted (ART) BOTOX Injection Technique: A Novel Paradigm for Migraines and Chronic Headaches

Anatomical Regional Targeted (ART) BOTOX Injection Technique: A Novel Paradigm for Migraines and Chronic Headaches

Surgical Management of Migraine Headaches

Management of Migraine Headaches: OnabotulinumtoxinA Injection

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