Abstract
Background
Endoscopic foreheadplasty surgery (EFS) is a common procedure, however little evidence exists describing the nature or treatment of postoperative headache pain and associated symptoms.
Objectives
Our objective was to describe the intensity, quality, location, and duration of headache pain in women following EFS. We also compared post EFS symptoms with migraine, described medication use and efficacy, and measured emotional and functional outcomes.
Methods
This descriptive study used an observational repeated measures design. Forty-two women (age mean±std=59.0±7.9 years) undergoing EFS were prospectively recruited from twelve private cosmetic practices in three California counties. Phone interviews with the Acute Short-Form 12v2, and Headache Questionnaires were conducted on postoperative days (POD) 1, 3, 7, and 30.
Results
At POD#1, 93% reported at least moderate pain and 64% severe pain. Severe pain was characterized as throbbing (71%), sharp (53%), dull (76%), exploding (41%), imploding (53%), continuous (53%) or intermittent (41%) on POD#1. Moderate pain was most frequent on POD#3 (21%) compared to POD#1 (19%), POD#7 and #30 (12%). Mild pain predominated on POD#3 (40%) and POD#7 (40%), with (20%) remaining on POD#30. The majority (79%) of post EFS symptoms commonly included light sensitivity and nausea, and therefore met most International Classification of Headache Disorders criteria for migraine. Analgesic use provided inconsistent relief. Functional and emotional status did not return to baseline throughout the 30-day postoperative period.
Conclusions
Immediately following EFS, most women experience moderate to severe headache pain, despite use of medications. Pain persists in many patients for up to a month. Headache is associated with migraine symptoms, including light sensitivity and nausea.