Surgical variation of microvascular decompression for trigeminal neuralgia: A technical note and anatomical study

Silva, da; Cc, de Almeida; Rf, Iglesio; Jm, de Navarro; Teixeira, MJ; Kp, Duarte

doi:10.4103/2152-7806.188916

Cited by 5 publications

(2 citation statements)

References 19 publications

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“…The dural opening into a “V” shape completely exposes the area between the angle of the transversal sigmoid sine 0.5 cm medially to the sinuses, which allows us to avoid significant cerebellar retraction ( Figure 3A ). Finally, we anchor the dural edge superiorly with Vicryl 5-0 suture ( 20 ).…”

Section: Surgical Techniquementioning

confidence: 99%

The outcomes of microvascular decompression for primary trigeminal neuralgia: insights from a single-center experience and technical advancements

Nurimanov,

Mammadinova,

Menlibayeva

et al. 2024

Front. Surg.

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BackgroundMicrovascular decompression (MVD) remains the primary surgical treatment for trigeminal neuralgia due to its positive postoperative results. This study aims to evaluate the outcomes of patients with primary trigeminal neuralgia who underwent MVD. Additionally, the paper offers a detailed explanation of the surgical methodology of MVD employed at the neurosurgical hospital in Kazakhstan.MethodsThe study involved 165 medical records of patients with trigeminal neuralgia who underwent MVD between 2018 and 2020. Out of these 165 patients, 90 (54.55%) were included in the final analysis and were further evaluated using the Barrow Neurological Institute pain intensity score. Various variables were analyzed, including age, sex, affected side, dermatomes, offending vessel, and surgical intervention type. Moreover, the surgical technique employed at the hospital was described.ResultsThe average follow-up period after the MVD procedure was 32.78 ± 9.91 months. The results indicated that out of the 90 patients, 80 (88.89%) achieved a good outcome as evidenced by BNI scores I and II. It was observed that patients with affected maxillary dermatomas and those with affected ophthalmic + maxillary dermatomas were more likely to experience fair + poor postsurgery BNI scores. On the other hand, patients with neurovascular conflicts involving the maxillary + mandibular dermatomas demonstrated good BNI scores (p = 0.01).ConclusionsThe outcomes of MVD in patients with primary trigeminal neuralgia showed good BNI scores within this study population. The outcome depended on the affected dermatome of the trigeminal nerve with the vessel. Additionally, patient positioning, intraoperative management including small skin incisions, minimal craniotomy, and precise closure of the dura, as well as intraoperative neurolysis, may contribute to achieving good clinical and satisfactory post-surgery aesthetic outcomes.

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Section: Surgical Techniquementioning

confidence: 99%

The outcomes of microvascular decompression for primary trigeminal neuralgia: insights from a single-center experience and technical advancements

Nurimanov,

Mammadinova,

Menlibayeva

et al. 2024

Front. Surg.

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“…Microvascular decompression (MVD) is the preferred surgical treatment for refractory trigeminal neuralgia (TN), hemifacial spasm (HFS), and glossopharyngeal neuralgia (GN), debilitating conditions of the 5 th , 7 th , and 9 th cranial nerves, respectively. [ 4 8 21 24 30 ] TN is characterized by paroxysmal, “lightning” pain in areas innervated by the trigeminal nerve,[ 18 ] HFS consists of recurrent, unilateral movements of muscles innervated by the facial nerve,[ 6 ] and GN includes sporadic ear, tongue, and throat pain triggered by chewing, swallowing, coughing, and speaking. [ 32 ] The most common cause of TN, HFS, and GN is compression of the trigeminal, facial, and glossopharyngeal nerves at the root entry zone from the brainstem.…”

Section: Introductionmentioning

confidence: 99%

Diabetes and morbid obesity are associated with higher reoperation rates following microvascular decompression surgery: An ACS-NSQIP analysis

et al. 2017

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Background:Microvascular decompression (MVD) is the preferred treatment for refractory trigeminal neuralgia, hemifacial spasm, and glossopharyngeal neuralgia. Despite its high rate of success, MVD carries risk of complications. In this study, we examine outcomes following MVD and identify risk factors associated with adverse outcomes.Methods:A review of the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was performed with CPT code 61458 queried between 2007 and 2014. Demographics, preoperative comorbidities, and 30-day outcomes were analyzed. Univariate and multivariate regression analyses were performed to identify predictors of reoperation and adverse events.Results:Five hundred and six craniotomies were studied. Nineteen (5.5%) instances of 30-day readmission were reported, with 14 (2.8%) patients returning to the operating room. No instances of death or hemorrhage requiring operation were reported. Morbid obesity (body mass index >40) (P = 0.030) and diabetes (P = 0.017) were associated with risk of reoperation. Age, operative time, and indication for surgery were not associated with significant differences in adverse events.Conclusions:MVD is a common and effective procedure with a relatively safe profile and low 30-day risk of reoperation. Advanced age is not associated with worse outcomes. Obesity and diabetes, however, are associated with increased risk of reoperation and may warrant additional precautions.

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Long-term results of various ways to eliminate neurovascular conflict in patients with classical trigeminal neuralgia

Balyazina,

Afanasyeva,

Balyazin

et al. 2024

jour

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Objective: to study the long-term results of the treatment of classical trigeminal neuralgia, depending on the method of eliminating neurovascular conflict. Material and methods: the study is based on the study of long-term results of treatment of classical trigeminal neuralgia in 261 patients who underwent microvascular decompression using various techniques to eliminate neurovascular conflict by processing archival medical histories, results of outpatient examinations and telephone interviews of patients. Results: the best long-term results were in patients for whom the elimination of neurovascular conflict was performed by moving the loop of the conflicting artery to a conflict-free position with its confinement in a muff-like microprotector. Conclusion: Prevention of the resumption of neurovascular conflict in the postoperative long-term period by enclosing the conflicting artery in a microprotector moved to a conflict-free position provides the best long-term results with less colic of the disease.

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Surgical variation of microvascular decompression for trigeminal neuralgia: A technical note and anatomical study

Cited by 5 publications

References 19 publications

The outcomes of microvascular decompression for primary trigeminal neuralgia: insights from a single-center experience and technical advancements

The outcomes of microvascular decompression for primary trigeminal neuralgia: insights from a single-center experience and technical advancements

Diabetes and morbid obesity are associated with higher reoperation rates following microvascular decompression surgery: An ACS-NSQIP analysis

Long-term results of various ways to eliminate neurovascular conflict in patients with classical trigeminal neuralgia

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