Clinical Study And Follow-up Results Of Micro-Vascular Decompression In Trigeminal Neuralgia

Objective:To study the clinical effect and follow-up results of micro vascular decompression in trigeminal neuralgia.Methods:A retrospective analysis of the clinical effect and follow-up results of micro-vascular decompression in24trigeminal neuralgia patients who were followed6to38months(average16.2months).Results:(1)The onset of trigeminal neuralgia in patients aged36-73years old(average55.7years).It occurred more frequently in women than men with a ratio of1.67:1.The pain in right side was more often than in left.75.0%patients were typical trigeminal neuralgia while25.0%were atypical.The rate is41.7%for the pain which affected the divisions V2+V3of the trigeminal nerve.(2)21patients had done MRI before the surgery.All of them found neurovascular compression on MRI.(3) The trigeminal root was compressed by the artery in83.3%patients in the operative findings,12.5%by the vein and4.2%by arteriovenous mix.(4) Immediate postoperative relief of pain was complete in87.5%patients, and absent in4.2%.Using Teflon felt to separate the offending vessels and the trigeminal nerve was better than other terylene. The complications included3severe nausea and vomiting(12.5%),2ipsilateral hearing loss(8.3%),1facial numbness(4.2%), no death or other major complications.(5)Patients were followed6-38months(average16.2months).4patients were lost to follow-up.17patient(85.0%) had excellent outcome,2patients (10.0%)had no effect after the surgery,1patient(5%) recurrence when7months after the surgery.We found that all3patients who appeared bad outcome had long duration of the disease(average6years), and the immediate postoperative relief of pain was not evident in2of them.ConclusionMicrovascular decompression has a high rate of long-term success for treating trigeminal neuralgia.MRI can be the routine examination before microvascular decompression.Teflon felt is beneficial to use in surgery for separating vessels and trigeminal nerve.Microvascular decompression is also both safe and effective in the elderly patients.The earlier to treat with microvascular decompression maybe the better effect after the surgery.