Long-Term Retrospective Analysis of Microvascular Decompression in Patients With Recurrent Trigeminal Neuralgia

Abstract

Objective: To explore the clinical characteristics of patients with recurrent trigeminal neuralgia (TN) and the experience of microvascular decompression (MVD) in the treatment of such patients.Methods: We retrospectively analyzed clinical data, imaging examination results, surgical methods, and treatment efficacies in 127 patients with recurrent typical TN from January 2005 to December 2014.Results: The age of the recurrent group was higher than that of the non-recurrent group (p < 0.05). The duration of pain before the first MVD procedure was longer in the recurrent group than in the non-recurrent group (p < 0.05). Patients in the recurrent group were more likely to have compression of the trigeminal nerve by the vertebrobasilar artery (VBA) or multiple vessels than patients in the non-recurrent group (p < 0.05). A Kaplan–Meier curve showed a median pain-free survival of 12 months after the first MVD procedure. The severity of pain (preoperative visual analog scale [VAS] score) in patients with recurrence was lower than that in patients with first-onset TN (p < 0.05). Vessel compression, Teflon compression or granuloma and arachnoid adhesion were considered the main causes of recurrence. Postoperative Barrow Neurological Institute (BNI) scores in the redo MVD group were excellent (T = 2) for 69 patients (53.33%) and good (T = 3) for 46 patients (36.22%). The postoperative follow-up was 63–167 months (105.92 ± 25.66). During the follow-up, no recurrence was noted. All complications were cured or improved.Conclusions: Microvascular decompression (MVD) is an effective surgical method for the treatment of TN. For recurrent patients, reoperation can achieve good results.

Long-Term Retrospective Analysis of Re-do Microvascular Decompression in Patients With Hemifacial Spasm

“…The preoperative management and operative technique were consistent with our previous studies (1,6). After the induction of general anesthesia, the patient was placed in the lateral park bench position with three-point fixation, and retrosigmoid craniotomy was performed.…”

“…Finally, Teflon granuloma is also a cause of recurrent HFS. In our previous study of 127 cases of recurrent trigeminal neuralgia, 23 cases were found to be caused by a granuloma ( 6 ). In this study, we also found the same situation in HFS patients.…”

A Prospective Study to Examine the Association of the Foramen Ovale Size with Intraluminal Pressure of Pear-Shaped Balloon in Percutaneous Balloon Compression for Trigeminal Neuralgia

“…However, many patients may refuse the open surgery and the surgery-related mortality rate was about 0.37% [ 26 ]. In addition, patients may present with recurrent pain due to vessel compression, Teflon compression, or granuloma and arachnoid adhesion [ 27 ].…”

Microvascular Decompression for Patient With Coexistent of Trigeminal Neuralgia, Hemifacial Spasm and Glossopharyngeal Neuralgia- a Case Report

“…In such patient, the bone window and dural incision should be mild wider than usual to fully expose NVCs, and it should be noted that we should rst dissected all the compressions and then inserted Te on patches. Once trigeminal decompression is totally accomplished, MVDs of facial nerve and glossopharyngeal nerve could be greatly restricted for limited operating space in such surgery and even result in patches shift and incomplete decompression or omission responsible vessels: two common recurrent factors of such diseases [17,18].…”