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J Neurol Surg B Skull Base 2021; 82(S 03): e295-e299
DOI: 10.1055/s-0040-1710520
Original Article

Treatment of Trigeminal Neuralgia with “Microvascular Decompression Plus” Technique

Ming-Xing Liu
1   Department of Neurosurgery, Qingdao Municipal Hospital, Qingdao, 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
,
Lei Xia
2   Department of Neurosurgery, XinHua Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, 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
,
Juanhong Shi
3   Department of Pathology, Tongji Hospital, Shanghai Tongji University, Shanghai, People's Republic of China
› Author Affiliations Funding This work was supported by the China's government under grant of National Natural Science Foundation (81471317).
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Abstract

Objective Although microvascular decompression (MVD) has been widely accepted as an effective treatment of trigeminal neuralgia (TN), some patients have not been cured. To improve the postoperative outcome, the surgical procedure should be further refined.

Design This is a retrospective study.

Setting Present study conducted at a cranial nerve disorder center.

Participants Clinical data were collected from patients with TN who had undergone surgery in our center, including 685 who had undergone traditional MVD and 576 who had undergone the “MVD plus” procedure, in which any vessel attached to the trigeminal nerve was freed away (“nerve-combing”), which was followed by intraoperative neurolysis.

Main Outcome Measures Postoperative outcomes and complications in the two groups were compared.

Results Among patients who underwent traditional MVD, the rates of immediate relief and 1-year relief were 89.9 and 86.9%, respectively; among patients who underwent MVD plus group, these rates were 95.1 and 94.6%, respectively (p = 0.05). Patients who underwent MVD plus initially exhibited a higher rate of facial numbness (p < 0.05), but this finding decreased over time and reached the same level as that in the traditional MVD group within 3 months (p > 0.05).

Conclusion Sufficient MVD with nerve-combing for the treatment of TN may produce a high rate of cure with less recurrence.

Keywords

microvascular decompression - trigeminal neuralgia - nerve-combing - surgical strategy


Publication History

Received: 10 September 2019

Accepted: 15 March 2020

Article published online:
19 May 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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