Prospective Comparison of Redo Microvascular Decompression and Percutaneous Balloon Compression as Primary Surgery for Recurrent Trigeminal Neuralgia
Journal of Korean Neurosurgical Society
;
: 747-752, 2018.
Article
in English
| WPRIM
| ID: wpr-788730
ABSTRACT
OBJECTIVE:
To prospectively compare facial pain outcomes for patients having either a repeat microvascular decompression (MVD) or percutaneous balloon compression (PBC) as their surgery for trigeminal neuralgia (TN) recurrence.METHODS:
Prospective cohort study of 110 patients with TN recurrence who had either redo MVD (n=68) or PBC (n=42) from July 2010 until September 2016. The mean follow-up was 45.6 months.RESULTS:
After redo MVD, 65 patients (95.6%) experienced immediate relief of pain. After PBC, 34 patients (81%) were immediately relieved of their neuralgia. After 1 month, the clinical effect of redo MVD was better than PBC (p < 0.01). Patients who had redo MVD more commonly were pain free off medications (93.4% at 1 year, 78.2% at 4 years) compared with the PBC patients (85.1% at 1 year, 59.3% at 4 years). However, mean length of stay was longer (p>0.05). Patients after PBC who occurred developed herpes simplex (35.7%), facial numbness (76.2%), and annoying dysesthesia (21.4%) more frequently compared with patients after redo MVD who occurred developed herpes simplex (14.7%), facial numbness (8.8%), and hypoesthesia (5.9%) (p < 0.05). The symptoms recurred respectively in 15 patients (22.1%) and 19 patients (45.2%) after redo MVD and PBC within the entire 6-year follow-up period.CONCLUSION:
For the patients with TN recurrence, redo MVD was a more effective procedure than PBC. The cure rate and immediate relief of pain were better, and the incidence of complications was lower.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Paresthesia
/
Recurrence
/
Trigeminal Neuralgia
/
Facial Pain
/
Incidence
/
Prospective Studies
/
Cohort Studies
/
Follow-Up Studies
/
Microvascular Decompression Surgery
/
Herpes Simplex
Type of study:
Etiology study
/
Incidence study
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Humans
Language:
English
Journal:
Journal of Korean Neurosurgical Society
Year:
2018
Type:
Article
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