Dr. Harry Salinas, Plastic Surgeon with Miami Cancer Institute, explains the first thing to do is taking a history, doing a physical and if they get a history that is consistent with the nerve entrapment syndrome, they tell the patient to see them when they are having a migraine and not to take any medications. He points out that if the symptoms are significantly alleviated by those blocks they offer them surgical decompression of the triggers.
Dr. Harry Salinas, Plastic Surgeon with Miami Cancer Institute, says migraines are more common in women than in men. According to Dr. Miguel Angel Medina, Director of Microsurgery with Miami Cancer Institute, there's a small predominance towards women, but it’s not an overwhelming predominance. Salinas highlights 50% of the patients that come in get complete relief, because they only operate on patients who respond to their diagnostic maneuvers, which are the nerve blocks.
Dr. Harry Salinas, Plastic Surgeon with Miami Cancer Institute, says 50% of patients will have complete resolution of their symptoms, and 80% of them will have a 50% improvement of their migraine headache index. Dr. Miguel Angel Medina, Director of Microsurgery with Miami Cancer Institute, explains they see the headache after surgery lasts less time, so if it used to last 8 hours now it lasts 4 hours, or 3 hours.
Dr. Harry Salinas, Plastic Surgeon with Miami Cancer Institute, says there are a lot of triggers that are very common for migraine patients, such as spicy foods, stress, alcohol, and sounds. He also explains that the patients that have surgically treatable migraines are patients whose trigger is actually a nerve compression syndrome. He says those patients are managed medically and are referred back to primary care physicians and neurologists who try a variety of medications to manage their symptoms.
Harry Salinas, Plastic Surgeon at Miami Cancer Institute, explains there is a huge range of skin cancers and he says about reconstructive surgery the following: "They're very common, non-melanoma skin cancers being the most common and it can be as simple as you just cut it out and close the wound, then you have a little linear scar or if the defect is bigger that we have to move some local tissue around". Salinas says there are some cancers that if neglected will grow and invade underlying structures and need big reconstructions, like the head of neck patients or the lower extremity patient.