Migraine Surgery Practice Patterns and Attitudes

Background: Minimally invasive techniques have been developed to treat migraine headache, and several reports have shown efficacy in treating select patients who are refractory to conventional therapies. Although there is a growing body of evidence supporting migraine surgery, no study has examined its adoption by plastic surgeons in the United States. Methods: A Web-based survey consisting of 17 ad hoc questions was designed to ascertain respondents' demographics, experience, knowledge, and attitudes regarding migraine surgery. After pilot testing, the survey was distributed by means of email to the entire membership of the American Society of Plastic Surgeons. Results: A total of 3747 American Society of Plastic Surgeons members were surveyed, and 193 surveys were completed, for a response rate of 5.2 percent. Thirty-four respondents (18 percent) had performed surgery to treat migraine headache. Among those who have performed migraine surgery, over 80 percent reported improvement in patient symptoms. Of those who have not performed migraine surgery, 60 percent would be interested if an appropriate patient was referred to them by a neurologist. Conclusion: Although there is interest in migraine surgery among a subset of plastic surgeons, significant barriers to performing migraine surgery include deficient referral patterns from neurologists and lack of familiarity with the concept and techniques of migraine surgery. (Plast. Reconstr. Surg. 129: 623, 2012.)