Prospective Comparison of Redo Microvascular Decompression and Percutaneous Balloon Compression as Primary Surgery for Recurrent Trigeminal Neuralgia
- Author:
Jing nan CHEN
1
;
Wen hua YU
;
Hang gen DU
;
Li JIANG
;
Xiao qiao DONG
;
Jie CAO
Author Information
- Publication Type:Original Article
- Keywords: Trigeminal neuralgia; Re-do; Microvascular decompression surgery; Percutaneous balloon compression
- MeSH: Cohort Studies; Facial Pain; Follow-Up Studies; Herpes Simplex; Humans; Hypesthesia; Incidence; Length of Stay; Microvascular Decompression Surgery; Neuralgia; Paresthesia; Prospective Studies; Recurrence; Trigeminal Neuralgia
- From:Journal of Korean Neurosurgical Society 2018;61(6):747-752
- CountryRepublic of Korea
- Language:English
- 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.
