Download PDF
J Neurol Surg A Cent Eur Neurosurg 2023; 84(05): 470-476
DOI: 10.1055/a-1994-7956
Review Article

A Comparative Review of the Outcome Following MVD and PBC in Patients with Trigeminal Neuralgia

Yi Zhou‡   *
1   Department of Neurosurgery, TaiHe Hospital, Hubei University of Medicine, Shiyan, Hubei, People's Republic of China
,
Ning-Ning Dou‡   *
2   Department of Neurosurgery, XinHua Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, People's Republic of China
,
Xue-Lai Liu
3   Department of Neurosurgery, LingYi Hospital of Traditional Chinese Medicine, Shandong, People's Republic of China
,
Hui Wang
1   Department of Neurosurgery, TaiHe Hospital, Hubei University of Medicine, Shiyan, Hubei, People's Republic of China
,
Jun Zhong
2   Department of Neurosurgery, XinHua Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, People's Republic of China
› Author Affiliations Funding None.
› Further Information
   Permissions and Reprints

Abstract

Background This study aims to systematically review the treatment outcomes of percutaneous balloon compression (PBC) and microvascular decompression (MVD) in patients with trigeminal neuralgia.

Methods A systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guideline was performed using PubMed, Embase, and Cochrane Central Registry of Controlled Trials databases. Only those articles with more than 5 years' follow-up length were included in this investigation. To uniformly assess the postoperative outcome, we defined pain relief as totally pain free, while the postoperative hospitalization and last follow-up period were defined as early and long term, respectively. The facial numbness was quantified with Barrow Neurological Institute Pain Intensity Score (BNI).

Results After database searching and screening, 7,797 cases were finally included according to the criteria. The early pain relief rates were 94.1% (1,551/1,649) and 89.9% (4,962/5,482) following PBC and MVD (odds ratio [OR] = 0.603; p < 0.05), while the long-term rates were 58.1% (921/1,566) and 74.9% (4,549/6,074; OR = 2.089; p < 0.05), respectively. Although a significant higher facial numbness occurred in the PBC group in the early stage, it was mostly diminished 5 years later compared with the MVD group. At long-term follow-up, hypoacusis and facial palsy occurred more often in the MVD group (p < 0.05).

Conclusions Both MVD and PBC provide a satisfactory outcome for the patients in the long term. As a simple, safe, and reliable technique, PBC should be considered as a viable alternative.

Keywords

trigeminal neuralgia - microvascular decompression - percutaneous balloon compression - long-term

Author Contributions

J.Z. contributed to the study conception and design. Material preparation, data collection, and analysis were performed by N.N.D., X.L.L., Y.Z. and H.W. The first draft of the manuscript was written by Y.Z., and all the authors commented on previous versions of the manuscript. All the authors read and approved the final manuscript.


* Drs Dou and Zhou contributed equally to this study.




Publication History

Received: 03 January 2022

Accepted: 05 December 2022

Accepted Manuscript online:
08 December 2022

Article published online:
11 May 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Cruccu G, Finnerup NB, Jensen TS. et al. Trigeminal neuralgia: new classification and diagnostic grading for practice and research. Neurology 2016; 87 (02) 220-228
    CrossrefPubMedGoogle Scholar
  • 2 Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia 2018; 38 (01) 1-211
    CrossrefPubMedGoogle Scholar
  • 3 Di Stefano G, La Cesa S, Truini A, Cruccu G. Natural history and outcome of 200 outpatients with classical trigeminal neuralgia treated with carbamazepine or oxcarbazepine in a tertiary centre for neuropathic pain. J Headache Pain 2014; 15 (01) 34
    CrossrefPubMedGoogle Scholar
  • 4 Jannetta PJ. Arterial compression of the trigeminal nerve at the pons in patients with trigeminal neuralgia. 1967. J Neurosurg 2007; 107 (01) 216-219
    CrossrefPubMedGoogle Scholar
  • 5 Panczykowski DM, Jani RH, Hughes MA, Sekula RF. Development and evaluation of a preoperative trigeminal neuralgia scoring system to predict long-term outcome following microvascular decompression. Neurosurgery 2020; 87 (01) 71-79
    CrossrefPubMedGoogle Scholar
  • 6 Zhong J, Zhu J, Sun H. et al. Microvascular decompression surgery: surgical principles and technical nuances based on 4000 cases. Neurol Res 2014; 36 (10) 882-893
    CrossrefPubMedGoogle Scholar
  • 7 Hai J, Li ST, Pan QG. Treatment of atypical trigeminal neuralgia with microvascular decompression. Neurol India 2006; 54 (01) 53-56 , discussion 57
    CrossrefPubMedGoogle Scholar
  • 8 Maarbjerg S, Gozalov A, Olesen J, Bendtsen L. Concomitant persistent pain in classical trigeminal neuralgia: evidence for different subtypes. Headache 2014; 54 (07) 1173-1183
    CrossrefPubMedGoogle Scholar
  • 9 Jawahar A, Wadhwa R, Berk C. et al. Assessment of pain control, quality of life, and predictors of success after gamma knife surgery for the treatment of trigeminal neuralgia. Neurosurg Focus 2005; 18 (05) E8
    CrossrefPubMedGoogle Scholar
  • 10 Kouzounias K, Lind G, Schechtmann G, Winter J, Linderoth B. Comparison of percutaneous balloon compression and glycerol rhizotomy for the treatment of trigeminal neuralgia. J Neurosurg 2010; 113 (03) 486-492
    CrossrefPubMedGoogle Scholar
  • 11 Lopez BC, Hamlyn PJ, Zakrzewska JM. Systematic review of ablative neurosurgical techniques for the treatment of trigeminal neuralgia. Neurosurgery 2004; 54 (04) 973-982 , discussion 982–983
    CrossrefPubMedGoogle Scholar
  • 12 Maesawa S, Salame C, Flickinger JC, Pirris S, Kondziolka D, Lunsford LD. Clinical outcomes after stereotactic radiosurgery for idiopathic trigeminal neuralgia. J Neurosurg 2001; 94 (01) 14-20
    CrossrefPubMedGoogle Scholar
  • 13 Mullan S, Lichtor T. Percutaneous microcompression of the trigeminal ganglion for trigeminal neuralgia. J Neurosurg 1983; 59 (06) 1007-1012
    CrossrefPubMedGoogle Scholar
  • 14 Zakrzewska JM, Lopez BC. Quality of reporting in evaluations of surgical treatment of trigeminal neuralgia: recommendations for future reports. Neurosurgery 2003; 53 (01) 110-120 , discussion 120–122
    CrossrefPubMedGoogle Scholar
  • 15 Rogers CL, Shetter AG, Fiedler JA, Smith KA, Han PP, Speiser BL. Gamma knife radiosurgery for trigeminal neuralgia: the initial experience of the Barrow Neurological Institute. Int J Radiat Oncol Biol Phys 2000; 47 (04) 1013-1019
    CrossrefPubMedGoogle Scholar
  • 16 Moher D, Liberati A, Tetzlaff J, Altman DG. PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ 2009; 339: b2535
    CrossrefPubMedGoogle Scholar
  • 17 Bederson JB, Wilson CB. Evaluation of microvascular decompression and partial sensory rhizotomy in 252 cases of trigeminal neuralgia. J Neurosurg 1989; 71 (03) 359-367
    CrossrefPubMedGoogle Scholar
  • 18 Lichtor T, Mullan JF. A 10-year follow-up review of percutaneous microcompression of the trigeminal ganglion. J Neurosurg 1990; 72 (01) 49-54
    CrossrefPubMedGoogle Scholar
  • 19 Sun T, Saito S, Nakai O, Ando T. Long-term results of microvascular decompression for trigeminal neuralgia with reference to probability of recurrence. Acta Neurochir (Wien) 1994; 126 (2–4): 144-148
    CrossrefPubMedGoogle Scholar
  • 20 Walchenbach R, Voormolen JH, Hermans J. Microvascular decompression for trigeminal neuralgia: a critical reappraisal. Clin Neurol Neurosurg 1994; 96 (04) 290-295
    CrossrefPubMedGoogle Scholar
  • 21 Barker II FG, Jannetta PJ, Bissonette DJ, Larkins MV, Jho HD. The long-term outcome of microvascular decompression for trigeminal neuralgia. N Engl J Med 1996; 334 (17) 1077-1083
    CrossrefPubMedGoogle Scholar
  • 22 Skirving DJ, Dan NG. A 20-year review of percutaneous balloon compression of the trigeminal ganglion. J Neurosurg 2001; 94 (06) 913-917
    CrossrefPubMedGoogle Scholar
  • 23 Tyler-Kabara EC, Kassam AB, Horowitz MH. et al. Predictors of outcome in surgically managed patients with typical and atypical trigeminal neuralgia: comparison of results following microvascular decompression. J Neurosurg 2002; 96 (03) 527-531
    CrossrefPubMedGoogle Scholar
  • 24 Sindou M, Leston J, Howeidy T, Decullier E, Chapuis F. Micro-vascular decompression for primary trigeminal neuralgia (typical or atypical). Long-term effectiveness on pain; prospective study with survival analysis in a consecutive series of 362 patients. Acta Neurochir (Wien) 2006; 148 (12) 1235-1245 , discussion 1245
    CrossrefPubMedGoogle Scholar
  • 25 Laghmari M, El Ouahabi A, Arkha Y, Derraz S, El Khamlichi A. Are the destructive neurosurgical techniques as effective as microvascular decompression in the management of trigeminal neuralgia?. Surg Neurol 2007; 68 (05) 505-512
    CrossrefPubMedGoogle Scholar
  • 26 Ferroli P, Acerbi F, Tomei M, Tringali G, Franzini A, Broggi G. Advanced age as a contraindication to microvascular decompression for drug-resistant trigeminal neuralgia: evidence of prejudice?. Neurol Sci 2010; 31 (01) 23-28
    CrossrefPubMedGoogle Scholar
  • 27 Günther T, Gerganov VM, Stieglitz L, Ludemann W, Samii A, Samii M. Microvascular decompression for trigeminal neuralgia in the elderly: long-term treatment outcome and comparison with younger patients. Neurosurgery 2009; 65 (03) 477-482 , discussion 482
    CrossrefPubMedGoogle Scholar
  • 28 Sarsam Z, Garcia-Fiñana M, Nurmikko TJ, Varma TR, Eldridge P. The long-term outcome of microvascular decompression for trigeminal neuralgia. Br J Neurosurg 2010; 24 (01) 18-25
    CrossrefPubMedGoogle Scholar
  • 29 Oesman C, Mooij JJ. Long-term follow-up of microvascular decompression for trigeminal neuralgia. Skull Base 2011; 21 (05) 313-322
    Article in Thieme ConnectPubMedGoogle Scholar
  • 30 Chen JF, Tu PH, Lee ST. Long-term follow-up of patients treated with percutaneous balloon compression for trigeminal neuralgia in Taiwan. World Neurosurg 2011; 76 (06) 586-591
    CrossrefPubMedGoogle Scholar
  • 31 Zhang H, Lei D, You C, Mao BY, Wu B, Fang Y. The long-term outcome predictors of pure microvascular decompression for primary trigeminal neuralgia. World Neurosurg 2013; 79 (5–6): 756-762
    CrossrefPubMedGoogle Scholar
  • 32 Abdennebi B, Guenane L. Technical considerations and outcome assessment in retrogasserian balloon compression for treatment of trigeminal neuralgia. Series of 901 patients. Surg Neurol Int 2014; 5: 118
    CrossrefPubMedGoogle Scholar
  • 33 Sandel T, Eide PK. Long-term results of microvascular decompression for trigeminal neuralgia and hemifacial spasms according to preoperative symptomatology. Acta Neurochir (Wien) 2013; 155 (09) 1681-1692 , discussion 1692
    CrossrefPubMedGoogle Scholar
  • 34 Masuoka J, Matsushima T, Inoue K, Nakahara Y, Takase Y, Kawashima M. Outcome of microvascular decompression for trigeminal neuralgia treated with the stitched sling retraction technique. Neurosurg Rev 2015; 38 (02) 361-365 , discussion 365
    CrossrefPubMedGoogle Scholar
  • 35 Liu R, Deng Z, Zhang L, Liu Y, Wang Z, Yu Y. The long-term outcomes and predictors of microvascular decompression with or without partial sensory rhizotomy for trigeminal neuralgia. J Pain Res 2020; 13: 301-312
    CrossrefPubMedGoogle Scholar
  • 36 Texakalidis P, Xenos D, Tora MS, Wetzel JS, Boulis NM. Comparative safety and efficacy of percutaneous approaches for the treatment of trigeminal neuralgia: a systematic review and meta-analysis. Clin Neurol Neurosurg 2019; 182: 112-122
    CrossrefPubMedGoogle Scholar
  • 37 Maarbjerg S, Gozalov A, Olesen J, Bendtsen L. Trigeminal neuralgia: a prospective systematic study of clinical characteristics in 158 patients. Headache 2014; 54 (10) 1574-1582
    CrossrefPubMedGoogle Scholar
  • 38 Gubian A, Rosahl SK. Meta-analysis on safety and efficacy of microsurgical and radiosurgical treatment of trigeminal neuralgia. World Neurosurg 2017; 103: 757-767
    CrossrefPubMedGoogle Scholar
  • 39 Sharma R, Phalak M, Katiyar V, Borkar S, Kale SS, Mahapatra AK. Microvascular decompression versus stereotactic radiosurgery as primary treatment modality for trigeminal neuralgia: a systematic review and meta-analysis of prospective comparative trials. Neurol India 2018; 66 (03) 688-694
    CrossrefPubMedGoogle Scholar
  • 40 Sekula RF, Marchan EM, Fletcher LH, Casey KF, Jannetta PJ. Microvascular decompression for trigeminal neuralgia in elderly patients. J Neurosurg 2008; 108 (04) 689-691
    CrossrefPubMedGoogle Scholar
  • 41 Sekula Jr RF, Frederickson AM, Jannetta PJ, Quigley MR, Aziz KM, Arnone GD. Microvascular decompression for elderly patients with trigeminal neuralgia: a prospective study and systematic review with meta-analysis. J Neurosurg 2011; 114 (01) 172-179
    CrossrefPubMedGoogle Scholar
  • 42 Ashkan K, Marsh H. Microvascular decompression for trigeminal neuralgia in the elderly: a review of the safety and efficacy. Neurosurgery 2004; 55 (04) 840-848 , discussion 848–850
    CrossrefPubMedGoogle Scholar
  • 43 Gusmão S, Oliveira M, Tazinaffo U, Honey CR. Percutaneous trigeminal nerve radiofrequency rhizotomy guided by computerized tomography fluoroscopy. Technical note. J Neurosurg 2003; 99 (04) 785-786
    CrossrefPubMedGoogle Scholar
  • 44 Bigder MG, Krishnan S, Cook EF, Kaufmann AM. Microsurgical rhizotomy for trigeminal neuralgia in MS patients: technique, patient satisfaction, and clinical outcomes. J Neurosurg 2018; 18 (06) 1877-1888
    CrossrefPubMedGoogle Scholar
  • 45 Kondziolka D, Lunsford LD. Percutaneous retrogasserian glycerol rhizotomy for trigeminal neuralgia: technique and expectations. Neurosurg Focus 2005; 18 (05) E7
    CrossrefPubMedGoogle Scholar
  • 46 Zhong J, Li ST, Xu SQ, Wan L, Wang X. Management of petrosal veins during microvascular decompression for trigeminal neuralgia. Neurol Res 2008; 30 (07) 697-700
    CrossrefPubMedGoogle Scholar
  • 47 Lovely TJ. Efficacy and complications of microvascular decompression: a review. Neurosurg Q 1998; 8 (02) 92-106
    CrossrefPubMedGoogle Scholar
  • 48 Brown JA, McDaniel MD, Weaver MT. Percutaneous trigeminal nerve compression for treatment of trigeminal neuralgia: results in 50 patients. Neurosurgery 1993; 32 (04) 570-573
    CrossrefPubMedGoogle Scholar
  • 49 Jia DZ, Li G. Bioresonance hypothesis: a new mechanism on the pathogenesis of trigeminal neuralgia. Med Hypotheses 2010; 74 (03) 505-507
    CrossrefPubMedGoogle Scholar
  • 50 Kanpolat Y, Savas A, Bekar A, Berk C. Percutaneous controlled radiofrequency trigeminal rhizotomy for the treatment of idiopathic trigeminal neuralgia: 25-year experience with 1,600 patients. Neurosurgery 2001; 48 (03) 524-532 , discussion 532–534
    CrossrefPubMedGoogle Scholar
  • 51 Nugent GR. Radiofrequency treatment of trigeminal neuralgia using a cordotomy-type electrode. A method. Neurosurg Clin N Am 1997; 8 (01) 41-52
    CrossrefPubMedGoogle Scholar
  • 52 Pollock BE, Phuong LK, Foote RL, Stafford SL, Gorman DA. High-dose trigeminal neuralgia radiosurgery associated with increased risk of trigeminal nerve dysfunction. Neurosurgery 2001; 49 (01) 58-62 , discussion 62–64
    PubMedGoogle Scholar
  • 53 Dos Santos MA, Pérez de Salcedo JB, Gutiérrez Diaz JA. et al. Outcome for patients with essential trigeminal neuralgia treated with linear accelerator stereotactic radiosurgery. Stereotact Funct Neurosurg 2011; 89 (04) 220-225
    CrossrefPubMedGoogle Scholar
  • 54 Inoue T, Hirai H, Shima A. et al. Long-term outcomes of microvascular decompression and Gamma Knife surgery for trigeminal neuralgia: a retrospective comparison study. Acta Neurochir (Wien) 2017; 159 (11) 2127-2135
    CrossrefPubMedGoogle Scholar
  • 55 Oh IH, Choi SK, Park BJ, Kim TS, Rhee BA, Lim YJ. The treatment outcome of elderly patients with idiopathic trigeminal neuralgia : micro-vascular decompression versus Gamma Knife radiosurgery. J Korean Neurosurg Soc 2008; 44 (04) 199-204
    CrossrefPubMedGoogle Scholar
  • 56 Gambeta E, Chichorro JG, Zamponi GW. Trigeminal neuralgia: an overview from pathophysiology to pharmacological treatments. Mol Pain 2020; 16: 1-18
    CrossrefPubMedGoogle Scholar
  • 57 Ghurye S, McMillan R. Orofacial pain: an update on diagnosis and management. Br Dent J 2017; 223 (09) 639-647
    CrossrefPubMedGoogle Scholar
  • 58 Rappaport HZ, Devor M. Trigeminal neuralgia: the role of self-sustaining discharge in the trigeminal ganglion. Pain 1994; 56 (02) 127-138
    CrossrefPubMedGoogle Scholar
  • 59 Liu M, Zhong J, Xia L, Dou N, Li S. The expression of voltage-gated sodium channels in trigeminal nerve following chronic constriction injury in rats. Int J Neurosci 2019; 129 (10) 955-962
    CrossrefPubMedGoogle Scholar
  • 60 Liu MX, Zhong J. Mechanism underlying cranial nerve rhizopathy. Med Hypotheses 2020; 142: 109801.10.1016
    PubMedGoogle Scholar
  • 61 Araya EI, Claudino RF, Piovesan EJ, Chichorro JG. Trigeminal neuralgia: basic and clinical aspects. Curr Neuropharmacol 2020; 18 (02) 109-119
    CrossrefPubMedGoogle Scholar
  • 62 Khodashenas M, Baghdadi G, Towhidkhah F. A modified Hodgkin-Huxley model to show the effect of motor cortex stimulation on the trigeminal neuralgia network. J Math Neurosci 2019; 9 (01) 4
    CrossrefPubMedGoogle Scholar
  • 63 Kumar S, Rastogi S, Kumar S, Mahendra P, Bansal M, Chandra L. Pain in trigeminal neuralgia: neurophysiology and measurement: a comprehensive review. J Med Life 2013; 6 (04) 383-388
    PubMedGoogle Scholar
  • 64 Brown JA, Hoeflinger B, Long PB. et al. Axon and ganglion cell injury in rabbits after percutaneous trigeminal balloon compression. Neurosurgery 1996; 38 (05) 993-1003 , discussion 1003–1004
    CrossrefPubMedGoogle Scholar
  • 65 Preul MC, Long PB, Brown JA, Velasco ME, Weaver MT. Autonomic and histopathological effects of percutaneous trigeminal ganglion compression in the rabbit. J Neurosurg 1990; 72 (06) 933-940
    CrossrefPubMedGoogle Scholar
  • 66 Devor M, Amir R, Rappaport ZH. Pathophysiology of trigeminal neuralgia: the ignition hypothesis. Clin J Pain 2002; 18 (01) 4-13
    CrossrefPubMedGoogle Scholar
  • 67 Liu HB, Ma Y, Zou JJ, Li XG. Percutaneous microballoon compression for trigeminal neuralgia. Chin Med J (Engl) 2007; 120 (03) 228-230
    CrossrefPubMedGoogle Scholar
  • 68 Lobato RD, Rivas JJ, Sarabia R, Lamas E. Percutaneous microcompression of the gasserian ganglion for trigeminal neuralgia. J Neurosurg 1990; 72 (04) 546-553
    CrossrefPubMedGoogle Scholar
  • 69 Omeis I, Smith D, Kim S, Murali R. Percutaneous balloon compression for the treatment of recurrent trigeminal neuralgia: long-term outcome in 29 patients. Stereotact Funct Neurosurg 2008; 86 (04) 259-265
    CrossrefPubMedGoogle Scholar
  • 70 Spatz AL, Zakrzewska JM, Kay EJ. Decision analysis of medical and surgical treatments for trigeminal neuralgia: how patient evaluations of benefits and risks affect the utility of treatment decisions. Pain 2007; 131 (03) 302-310
    CrossrefPubMedGoogle Scholar
  • 71 Kouzounias K, Schechtmann G, Lind G, Winter J, Linderoth B. Factors that influence outcome of percutaneous balloon compression in the treatment of trigeminal neuralgia. Neurosurgery 2010; 67 (04) 925-934 , discussion 934
    CrossrefPubMedGoogle Scholar
  • 72 Lee ST, Chen JF. Percutaneous trigeminal ganglion balloon compression for treatment of trigeminal neuralgia—part I: pressure recordings. Surg Neurol 2003; 59 (01) 63-66 , discussion 66–67
    CrossrefPubMedGoogle Scholar
  • 73 Lee ST, Chen JF. Percutaneous trigeminal ganglion balloon compression for treatment of trigeminal neuralgia, part II: results related to compression duration. Surg Neurol 2003; 60 (02) 149-153 , discussion 153–154
    CrossrefPubMedGoogle Scholar
  • 74 Park SS, Lee MK, Kim JW, Jung JY, Kim IS, Ghang CG. Percutaneous balloon compression of trigeminal ganglion for the treatment of idiopathic trigeminal neuralgia : experience in 50 patients. J Korean Neurosurg Soc 2008; 43 (04) 186-189
    CrossrefPubMedGoogle Scholar
  • 75 Unal TC, Unal OF, Barlas O. et al. Factors determining the outcome in trigeminal neuralgia treated with percutaneous balloon compression. World Neurosurg 2017; 107: 69-74
    CrossrefPubMedGoogle Scholar