Repeat Operations in Failed Microvascular Decompression for Trigeminal Neuralgia

Predicting the Outcome of Microvascular Decompression for Trigeminal Neuralgia Using Magnetic Resonance Tomographic Angiography

“…Operative treatment in current use includes neurectomy, radiofrequency thermal ablation, balloon compression, glycerol injections, radiosurgery, and MVD, among which only MVD is an etiology-oriented surgical modality aiming at relieving the symptom and complete preservation of nerve function. The immediate success rates of MVD for the treatment of trigeminal neuralgia are 83-94%, 6,7 but the incidence of recurrence has been reported to range from 3% to 30%, 6,8,9,19 with annual rates of recurrence of 2-3.5% during long-term followup. 10,11 In our study, the rate of recurrence of tic and failure of MVD was 9%.…”

Outcome Predictors After Gamma Knife Radiosurgery for Recurrent Trigeminal Neuralgia

“…13 Barker et al 1 observed that a previous ablative procedure did not lessen a patient's likelihood of having pain relief after MVD; however, deafferentation sequelae were higher if the patient underwent RFL before MVD. Cho et al 27 reported that approximately half of patients with TN who required repeat MVD developed recurrent pain.…”

Application of MRI and intraoperative CT fusion images with integrated neuronavigation in percutaneous radiofrequency trigeminal rhizotomy

“…One recent series reported a 92.3 % pain relief rate within the first 2 years of percutaneous RF-TR in patients with recurrence after microvascular decompression, and the long-term result was better in the neuronavigation-assisted group [20]. Some studies also reported a higher risk of surgical morbidity and lower successful rate with repeated microvascular decompression in recurrent cases [5,13,18]. Radiosurgery seems to be less effective as a salvage treatment for recurrent trigeminal neuralgia.…”

“…Most previous studies emphasized the effectiveness and long-term outcome of the first treatment. Some reports showed repeated microvascular decompression surgery for recurrent trigeminal neuralgia was frequently unsuccessful and that there was greater surgical morbidity due to adhesion [3,5,18]. The pathologic finding in about half of the second explorations was negative in one study and the patients underwent rhizotomy treatment [5].…”

“…Some reports showed repeated microvascular decompression surgery for recurrent trigeminal neuralgia was frequently unsuccessful and that there was greater surgical morbidity due to adhesion [3,5,18]. The pathologic finding in about half of the second explorations was negative in one study and the patients underwent rhizotomy treatment [5]. There is a lack of evidence regarding the immediate and long-term outcome of the second or third percutaneous radiofrequency rhizotomy and of well-designed comparable studies on the treatment of persistent or recurrent trigeminal neuralgia.…”