Clinical Analysis Of 54 Cases Of Primary Trigeminal Neuralgia Treated By Microvascular Decompression

OBJECTIVE:To evaluate the long-term efficacy and safety of microvascular decompression(MVD)in the treatment of primary trigeminal neuralgia(PTN),and to explore the factors that affect the efficacy.METHODS:A total of 54 patients with PTN were treated with MVD from the Department of Neurosurgery at the Dalian Municipal Central Hospital Affiliated of Dalian Medical University from September 2010 to October 2016.The follow-up included facial pain relief,recurrence.Whether the occurrence of postoperative complications.RESULTS:According to Brisman criteria,54 patients,44 cases were cured,5 cases of pain obviously relief,pain relief 3 cases,2 cases of pain than before no change.Long-term observation,the cure rate was 81.5%,the obviously effective rate was 9.2%,the effective rate was 5.6%,the inefficiency rate was 3.7%,the overall effective rate was 96.3%,postoperative nausea and vomiting in 19 cases,the ipsilateral facial numbness in 2 cases,4 cases of ipsilateral facial paralysis,2 cases of ipsilateral hearing impairment,1 case of cerebrospinal fluid rhinorrhea,3 cases of subcutaneous hydorps,5 cases of oral herpes,no cerebral infarction patients.Followed for 60 months,3 cases of pain recurrence.CONCLUSIONS:Abnormal blood vessels have a major cause of primary trigeminal neuralgia in the oppression of the trigeminal nerve stem and the thickening of the auricle around the nerve root.The study found that the course of the disease is short and the symptoms are typical and the vessel is responsible for the arteries,The exact decompression of patients,postoperative efficacy is better,on the contrary,longer duration,symptoms are not typical,the responsibility of blood vessels for the common arterial and dynamic oppression,decompression in patients with poor efficacy is not good.Microvascular decompression treatment of primary trigeminal neuralgia is effective,intraoperative exploration of REZ area,the effective protection of the vein,fine operation,the exact decompression,can effectively reduce the complications and reduce the recurrence rate.