Migraine surgery using the Miskoski method primarily aims to alleviate chronic migraine headaches by decompression of specific peripheral nerves that have been identified as trigger points. The procedure begins with a thorough preoperative assessment, including identification of the headache patterns and specific nerve triggers through detailed patient history and physical examinations. Imaging studies like Magnetic Resonance Imaging (MRI) or Computed Tomography (CT) scans may be utilized to rule out other intracranial pathologies. Before surgery, the patient is usually placed under general anesthesia. The surgeon then makes small incisions in the areas where the target peripheral nerves are located, which typically include the frontal, temporal, occipital, and nasal regions. For instance, decompression might involve removing small segments of muscle, fascia, or vessels that impinge on the nerves such as the supraorbital, supratrochlear, zygomaticotemporal, and greater occipital nerves. The goal is to reduce nerve irritation and subsequent migraine triggers.

Once the decompression is complete, the surgical sites are carefully closed using sutures, and the patient is monitored post-operatively for any immediate complications. Typically, the recovery period involves managing mild swelling and discomfort, with most patients returning to their normal activities within a few weeks. Follow-up appointments are essential to monitor healing and assess the reduction in migraine frequency and intensity. Many patients report significant improvements in their quality of life post-surgery, with a notable decrease in the occurrence and severity of migraines. Long-term outcomes can vary, and as such, continuous evaluation and patient feedback are critical to ensure successful results. The Miskoski method offers a viable surgical option for those suffering from debilitating chronic migraines when conventional medical treatments have failed.