Will Auriculotemporal Nerve Decompression Help My Migraines?
Q: Dr. Eppley, I suffer from migraine at my right temple and rarely at the left. Because medicines never helped me, I had a surgery in last August,. The surgeon cauterized many arteries of mine. My quality of life improved but I still have pain at the same places, though less severe in general. Months before the surgery, I had tried Botox (injected by a neurologist) and it did not help at all. Will the auricular-temporal decompression surgery help me? I appreciate your attention to my concerns.
A: With temporal migraines, the question is whether zygomaticotemporal and/or supraorbital nerve decompression would be helpful. A good diagnostic test would be Botox injections. Just because you have had Botox and had no benefit does not mean that the injections were placed in the proper locations. I have seen many Botox injections done by neurologists and other doctors that were not properly placed. They must be placed in the exact location of the course of the nerve to work. If effective, then these nerve decompressions could be very helpful.
I would not expect auriculotemporal nerve decompression/avulsion to be helpful based on the information provided. It rarely when done alone can produce significant migraine symptom improvement. If one is going to surgery, it would be best to do multiple nerve decompressions including the zygomaticotemporal, supraorbital and auriculotemporal nerves at the same time. This would be most likely to produce migraine intensity and frequency improvement.
Dr. Barry Eppley