The efficacy and safety of nerve combing for trigeminal neuralgia without neurovascular compression.

OBJECTIVE: The purpose of our study was to review and evaluate the efficacy and safety of nerve combing without neurovascular decompression for trigeminal neuralgia. METHODS: A retrospective review of 298 patients with trigeminal neuralgia between August 2007 and August 2016 was conducted. The patients were divided into two groups: the A group was treated by nerve combing (34 patients) and the B group received microvascular decompression (264 patients). Surgical outcomes and postoperative complications were compared between the two groups. RESULTS: Pain was completely relieved in 88.2% of group A patients and 92.8% of group B after surgery. The median duration of follow-up was 60 months (range 10-115 months) in group A and 62 months (range 12-118 months) in group B. 72.7% and 86.4% of cases were completely relieved in groups A and B, respectively. There were no statistically significant differences in the surgical outcomes between the two groups. Almost all patients experienced some degree of numbness or hypesthesia (76.5%). The rate of facial numbness in group A was significantly higher than that in group B. CONCLUSION: This study demonstrated that nerve combing without neurovascular decompression is a safe and effective treatment for trigeminal neuralgia. However, a majority of patients treated with nerve combing experienced some degree of facial numbness.

Microvascular decompression for hemifacial spasm associated with the vertebral artery.

The aim of this study was to discuss the baseline characteristics of hemifacial spasm (HFS) associated with the vertebral artery (VA) and evaluate microvascular decompression (MVD) as a surgical treatment of the associated HFS. From February 2010 to February 2015, 118 consecutive patients with HFS underwent MVD. Of these, 29 cases of HFS were associated with VA, this series was compared with the remaining non-VA-associated HFS. Of the 29 cases of VA-associated HFS, the VA was directly compressing the root exit zone (REZ) in eight cases. In the other 21 cases, the VA contacted REZ indirectly via its branches. The symptoms were completely relieved in 26 cases (89.7%) and partially relieved in another two cases (6.9%). Between the VA-associated group and non-VA-associated group, no statistically significant difference existed in the surgical results. VA-associated HFS is not a rare condition. For all cases of VA-associated HFS, indirect compression due to VA was more common. MVD for VA-associated HFS still can achieve good results.

Second microvascular decompression for trigeminal neuralgia in recurrent cases after microvascular decompression.

OBJECTIVES: The objectives of this work are to report the outcomes of our finding during microvascular decompression (MVD) for patients with recurrent trigeminal neuralgia (TN) and to introduce the sling retraction technique. METHODS: The authors performed a retrospective review of redo MVD for consecutive cases with recurrent TN after previous operation. Sling retraction techniques were used during the reoperation. RESULTS: Fifteen patients underwent redo MVD. During the second operation, arachnoid adhesion of the Teflon felt was confirmed at the trigeminal nerve in 10 cases, and neurovascular conflict was found in 4 cases. Symptoms were completely relieved in 14 patients (93.3%) and partially relieved in 1 patient (6.7%). The mean follow-up period was 38 months (range, 21-60 months), and no patient experienced recurrence. CONCLUSIONS: Arachnoid adhesion of the Teflon felt and vascular compression to the nerve were main causes of recurrence. The sling retraction technique is still an effective and useful treatment for recurrent TN after MVD.

The efficacy and safety of microvascular decompression for idiopathic trigeminal neuralgia in patients older than 65 years.

OBJECTIVE: The aim of this study was to review the efficacy and safety of microvascular decompression (MVD) for idiopathic trigeminal neuralgia (ITN) in elderly patients older than 65 years. METHODS: From June 2006 to June 2011, a total of 59 elderly patients with ITN underwent MVD. We performed a retrospective study of the medical records and compared the outcome data with those from 164 patients younger than 64 years during the same period. RESULTS: The mean age of the elderly and younger patient groups was 72 and 55 years. The pain was completely relieved in 93.2% and partially relieved in another 5.1% of the elderly patient group after surgery. The mean follow-up period was 42 months (range, 16-75 mo). A total of 8.9% of the patients in the elderly patient group experienced recurrence. Headaches, nausea, and vomiting were more frequent complications. There were no mortalities and severe morbidities after surgery. Between the elderly and younger patient groups, no statistically significant differences existed in the outcomes. CONCLUSIONS: Microvascular decompression is a safe and effective procedure for elderly patients with ITN. It is recommended that any patients with ITN should have the opportunity to choose MVD, unless their condition cannot tolerate general anesthesia.

Synthesis and structure characterization of new 1,2,4-oxadiazolo[4,5-d]-1,5-benzothiazepines derivatives containing 2-phenyl-1,2,3-triazole through 1,3-dipolar cycloaddition reaction.

Reaction of 1,5-benzothiazepines, containing 2-phenyl-1,2,3-triazole 2a-d, with aryl nitrile oxides in CH2 Cl2 at room temperature leads to a series of novel 1,2,4-oxadiazolo[4,5-d]-1,5-benzothiazepine derivatives 3a-l in good yields. The products were characterized by IR, 1H NMR, MS, elemental analyses, X-ray and their spectrum characters were discussed.