First-of-a-kind surgery in US for severe headaches

August 18, 2014
Surgeons at The Ohio State University Wexner Medical Center insert the nation's first neurostimulator designed to treat severe headaches known as cluster headaches. The tiny neurostimulator, which is attached to a patient`s cheekbone, has a wire that feeds directly into the nerves that are associated with cluster headaches. Once in place, patients use a hand-held device to activate the neurostimulator and `turn off`the pain they get from cluster headaches. Credit: The Ohio State University Wexner Medical Center

For those suffering excruciating pain from cluster headaches, relief may soon be available from an investigational device being studied in a national multicenter clinical trial. Recently, doctors at The Ohio State University Wexner Medical Center performed the first surgery in the United States to insert a neurostimulator to provide relief from cluster headaches, which are more painful than migraines. "Cluster headache is one of the most severe and disabling chronic pain conditions known to humankind. That's why it's important to look at options to help these patients," said Dr. Ali Rezai, director of the Neuroscience program at Ohio State's Wexner Medical Center and one of the scientific developers of this technology.

During the outpatient surgery, sinus surgeon Dr. Bradley Otto and oral surgeon Dr. Peter Larsen inserted the device through a small incision in the patient's gum into the side of the face affected by cluster headaches. Autonomic Technologies Inc. developed the miniaturized, multi­channel peripheral nerve stimulator, which is smaller than an almond, to stimulate the sphenopalatine ganglion (SPG). The SPG is a nerve bundle located behind the nose and is known to play a major role in severe headaches.

"Through an incision about 2 centimeters long, we're able to place this device, then pass it around the back of the maxillary sinus, or the cheek sinus, into this area where this ganglion is situated," said Larsen, who is professor of oral and maxillofacial surgery in the College of Dentistry at Ohio State. "The device is very small, and the patient doesn't even sense that it's there."

When patients begin to feel a starting, they hold the rechargeable handheld remote controller to their cheek to activate the stimulator to block the . The patient's physician can program the device to give the appropriate length and strength of stimulation.

A tiny, experimental neurostimulator, like this one, is being tested for the first time in patients in the US to treat cluster headaches. Doctors at The Ohio State University Wexner Medical Center say the neurostimulator has a wire (not visible) that feeds into the nerves behind the sinus cavity, which are associated with cluster headaches. A hand-held device is used to activate the stimulator and 'short circuit' the pain signals. Credit: The Ohio State University Wexner Medical Center

"This nerve control center sits behind the cheek sinus and is involved in the transmission pathway of cluster headache," said Otto, who is director of rhinology in the Department of Otolaryngology at Ohio State. "And so by blocking or short­circuiting that involvement, we think it will help treat cluster headache. The beauty of the device is that there are no internal batteries or other structures that need to be routinely removed. So, once we make the incision in the mouth and we place this device back behind the cheek sinus, it can be left forever."

The video will load shortly.
During a recent operation, surgeons at The Ohio State University Wexner Medical Center became the first in the United States to insert a tiny neurostimulator into a patient`s cheekbone, in an effort to treat his cluster headaches. This is the first of 120 surgeries that will take place in this multi-center trial over the next few years. Credit: The Ohio State University Wexner Medical Center

It's estimated that nearly 400,000 people in the United States suffer from cluster headache, which can happen many times each day, with each one lasting from 15 minutes to three hours. Cluster headache is often called "suicide headache" because the is so intense. Cluster headaches typically involve one side of the head, and are much more common in men. The headaches are so severe that they cause very disabling sharp and stabbing pain around and in the affected eye, along with pain in the nose, head and temple. Drooping eyelids, redness and tearing often accompany the eye pain, and there is no cure. "SPG interventions have been around for the past 100 years," said Rezai, including using anesthetics to block the SPG to surgical procedures to cut the SPG or chemically burning it. ""The main advantage of neurostimulation is that it's reversible and adjustable, and you're just modulating and blocking the pain signals."

In all, up to 120 patients with cluster headaches will receive the experimental device as part of the multi­center clinical trial that will last several years.

Explore further: Season's change can bring on cluster headaches

Related Stories

Season's change can bring on cluster headaches

June 27, 2014
(HealthDay)—Nearly 1 million Americans face the threat of cluster headaches since summer officially arrived, an expert says.

Headaches during sex likely more common than reported

June 10, 2014
About 1 percent of adults report they have experienced headaches associated with sexual activity and that such headaches can be severe.

Botox to treat 'suicide' headaches

November 1, 2013
"I hit myself in the head to distract myself from the pain when I have a cluster headache. The pain is indescribable hell, and in desperate moments, I have hit my head against a brick wall and hit myself in the head with ...

Surgery doubted as a migraine reliever

June 27, 2014
(HealthDay)—Migraine surgery is increasingly touted as a potential "cure" for the debilitating headaches, but researchers say the evidence just isn't there to support those claims.

Recommended for you

Study shows electric bandages can fight biofilm infection, antimicrobial resistance

November 6, 2017
Researchers at The Ohio State University Wexner Medical Center have shown - for the first time - that special bandages using weak electric fields to disrupt bacterial biofilm infection can prevent infections, combat antibiotic ...

Obesity increases incidence, severity, costs of knee dislocations

November 3, 2017
A new study of more than 19,000 knee dislocation cases in the U.S. between 2000 and 2012 provides a painful indication of how the nation's obesity epidemic is changing the risk, severity and cost of a traumatic injury.

Defining optimal opioid pain medication prescription length following surgery

September 27, 2017
A new study led by researchers at the Center for Surgery and Public Health at Brigham and Women's Hospital analyzed opioid prescription data from the Department of Defense Military Health System Data Repository, identifying ...

Is older blood OK to use in a transfusion?

September 27, 2017
(HealthDay)—Using older red blood cells to give transfusions to critically ill patients doesn't appear to affect their risk of dying, Australian researchers report.

One weight-loss surgery shows lasting results

September 21, 2017
(HealthDay)—Obesity surgery can have long-lasting effects on weight and the risk of developing type 2 diabetes and high blood pressure, a new study finds.

Hold the phone: An ambulance might lower your chances of surviving some injuries

September 20, 2017
Victims of gunshots and stabbings are significantly less likely to die if they're taken to the trauma center by a private vehicle than ground emergency medical services (EMS), according to results of a new analysis.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.