Efficacies of gamma knife and neuro-microsurgery in patients with recurrent trigeminal neuralgia after microvascular decompression: a comparative study
10.3760/cma.j.cn115354-20200814-00652
- VernacularTitle:伽马刀与显微外科手术对三叉神经痛显微血管减压术后复发患者的疗效对比研究
- Author:
Xuhui WANG
1
;
Mingliang REN
;
Hong LIANG
;
Hao WANG
;
Xuzhi HE
;
Bing LI
;
Mingwei XU
;
Ying CHEN
;
Minhui XU
;
Chun ZHOU
;
Lunshan XU
Author Information
1. 陆军军医大学大坪医院神经外科，重庆 400042
- Keywords:
Trigeminal neuralgia;
Gamma Knife;
Microvascular decompression;
Recurrence
- From:
Chinese Journal of Neuromedicine
2020;19(11):1085-1089
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To determine the difference of curative effects of gamma knife treatment and microsurgery on patients with recurrent trigeminal neuralgia (TN) after microvascular decompression (MVD).Methods:From January 2011 to December 2018, 65 patients with recurrent TN after MVD were enrolled in the study; 40 patients received gamma knife treatment and 25 patients received secondary microsurgical treatment. Barrow Neurological Institute (BNI) proposed pain grading was used to evaluate the efficacies right after treatment and 3 years after follow-up in all patients, and grading I-III was defined as pain relief.Results:Patients received gamma knife treatment had pain relief within 4-10 weeks of treatment and disappeared gradually; patients received secondary microsurgical treatment had disappeared facial pain immediately after waking up from anesthesia or completely alleviated facial pain within one week of treatment. Up to 3 years after surgery, follow-up results showed that 17 patients (68.0%) in the gamma knife treatment group had pain relief, and 16 patients (94.1%) in the microsurgical treatment group had pain relief; the difference in pain relief rate between the two groups was statistically significant ( χ2=4.100, P=0.043). Facial numbness was noted in the gamma knife treatment group, with an incidence of 24.0%; in the microsurgical treatment group, hemiplegia was noted in one patient and facial numbness was noted in the left ones, with complication rate of 29.4%; and the difference in complication rate between the two groups was not statistically significant ( χ2=0.010, P=0.921). Conclusion:For patients with recurrent TN after MVD, secondary microsurgical treatment and gamma knife treatment are safe and effective, among which secondary microsurgical treatment is more effective than gamma knife treatment.
