Trigeminal neuralgia: What are the important factors for good operative outcomes with microvascular decompression

Shi Ting Li, Qinggang Pan, Ningtao Liu, Feng Shen, Zhong Liu, Yuhang Guan, Marc Sindou, Kim Burchiel

Research output: Contribution to journalArticle

63 Citations (Scopus)

Abstract

Background Microvascular decompression has been widely used as the first choice in treating trigeminal neuralgia, but in a few patients, facial pain cannot be effectively controlled by microvascular decompression. We sought to clarify the important factors for good operative outcomes. Methods We reviewed 62 patients with trigeminal neuralgia treated by microvascular decompression during the period 2000 through 2002, including clinical presentation, operative findings, techniques, and outcomes. Neurovascular conflicts were divided into single contact, contact and indentation, single adhesion, adhesion and indentation, and trigeminal nerve atrophy. Operative outcomes were graded into immediate postoperative complete pain relief (excellent), delayed postoperative complete pain relief (better), significant pain relief (good), and no response to microvascular decompression (poor). Results All patients' presentations were typical at the time of pain onset, but the symptom in 17 patients changed to atypical before surgery. During operation, single contact and single adhesion was found in 14 patients and 15 patients, respectively; contact or adhesion in combination with indentation was found in 7 patients and 18 patients, respectively; atrophy occurred in 8 patients. Postoperatively, immediate and delayed complete pain relief was achieved in 32 (51.6%) patients and 17 (27.4%) patients, respectively; 11(17.7%) patients got significant pain relief; and 2 patients showed no response. The overall rate of complete pain relief in patients with shorter duration, typical presentation, artery compression and complete decompression was higher than that in patients with longer duration, atypical presentation, venous compression, and incomplete decompression. Conclusions Shorter duration, typical presentation, single artery compression, and complete decompression are the positive factors for better operative outcomes with microvascular decompression. Worse outcomes are usually related to venous compression, longer duration, and atypical presentation.

Original languageEnglish (US)
Pages (from-to)400-405
Number of pages6
JournalSurgical Neurology
Volume62
Issue number5
DOIs
StatePublished - Nov 2004
Externally publishedYes

Fingerprint

Microvascular Decompression Surgery
Trigeminal Neuralgia
Pain
Decompression
Postoperative Pain
Atrophy
Arteries
Facial Pain
Trigeminal Nerve

Keywords

  • microvascular decompression
  • operative outcomes
  • prognostic factors
  • Trigeminal neuralgia

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Trigeminal neuralgia : What are the important factors for good operative outcomes with microvascular decompression. / Li, Shi Ting; Pan, Qinggang; Liu, Ningtao; Shen, Feng; Liu, Zhong; Guan, Yuhang; Sindou, Marc; Burchiel, Kim.

In: Surgical Neurology, Vol. 62, No. 5, 11.2004, p. 400-405.

Research output: Contribution to journalArticle

Li, Shi Ting ; Pan, Qinggang ; Liu, Ningtao ; Shen, Feng ; Liu, Zhong ; Guan, Yuhang ; Sindou, Marc ; Burchiel, Kim. / Trigeminal neuralgia : What are the important factors for good operative outcomes with microvascular decompression. In: Surgical Neurology. 2004 ; Vol. 62, No. 5. pp. 400-405.
@article{4e7d50d33f1f42aa98dd614f5a3f36bd,
title = "Trigeminal neuralgia: What are the important factors for good operative outcomes with microvascular decompression",
abstract = "Background Microvascular decompression has been widely used as the first choice in treating trigeminal neuralgia, but in a few patients, facial pain cannot be effectively controlled by microvascular decompression. We sought to clarify the important factors for good operative outcomes. Methods We reviewed 62 patients with trigeminal neuralgia treated by microvascular decompression during the period 2000 through 2002, including clinical presentation, operative findings, techniques, and outcomes. Neurovascular conflicts were divided into single contact, contact and indentation, single adhesion, adhesion and indentation, and trigeminal nerve atrophy. Operative outcomes were graded into immediate postoperative complete pain relief (excellent), delayed postoperative complete pain relief (better), significant pain relief (good), and no response to microvascular decompression (poor). Results All patients' presentations were typical at the time of pain onset, but the symptom in 17 patients changed to atypical before surgery. During operation, single contact and single adhesion was found in 14 patients and 15 patients, respectively; contact or adhesion in combination with indentation was found in 7 patients and 18 patients, respectively; atrophy occurred in 8 patients. Postoperatively, immediate and delayed complete pain relief was achieved in 32 (51.6{\%}) patients and 17 (27.4{\%}) patients, respectively; 11(17.7{\%}) patients got significant pain relief; and 2 patients showed no response. The overall rate of complete pain relief in patients with shorter duration, typical presentation, artery compression and complete decompression was higher than that in patients with longer duration, atypical presentation, venous compression, and incomplete decompression. Conclusions Shorter duration, typical presentation, single artery compression, and complete decompression are the positive factors for better operative outcomes with microvascular decompression. Worse outcomes are usually related to venous compression, longer duration, and atypical presentation.",
keywords = "microvascular decompression, operative outcomes, prognostic factors, Trigeminal neuralgia",
author = "Li, {Shi Ting} and Qinggang Pan and Ningtao Liu and Feng Shen and Zhong Liu and Yuhang Guan and Marc Sindou and Kim Burchiel",
year = "2004",
month = "11",
doi = "10.1016/j.surneu.2004.02.028",
language = "English (US)",
volume = "62",
pages = "400--405",
journal = "World Neurosurgery",
issn = "1878-8750",
publisher = "Elsevier Inc.",
number = "5",

}

TY - JOUR

T1 - Trigeminal neuralgia

T2 - What are the important factors for good operative outcomes with microvascular decompression

AU - Li, Shi Ting

AU - Pan, Qinggang

AU - Liu, Ningtao

AU - Shen, Feng

AU - Liu, Zhong

AU - Guan, Yuhang

AU - Sindou, Marc

AU - Burchiel, Kim

PY - 2004/11

Y1 - 2004/11

N2 - Background Microvascular decompression has been widely used as the first choice in treating trigeminal neuralgia, but in a few patients, facial pain cannot be effectively controlled by microvascular decompression. We sought to clarify the important factors for good operative outcomes. Methods We reviewed 62 patients with trigeminal neuralgia treated by microvascular decompression during the period 2000 through 2002, including clinical presentation, operative findings, techniques, and outcomes. Neurovascular conflicts were divided into single contact, contact and indentation, single adhesion, adhesion and indentation, and trigeminal nerve atrophy. Operative outcomes were graded into immediate postoperative complete pain relief (excellent), delayed postoperative complete pain relief (better), significant pain relief (good), and no response to microvascular decompression (poor). Results All patients' presentations were typical at the time of pain onset, but the symptom in 17 patients changed to atypical before surgery. During operation, single contact and single adhesion was found in 14 patients and 15 patients, respectively; contact or adhesion in combination with indentation was found in 7 patients and 18 patients, respectively; atrophy occurred in 8 patients. Postoperatively, immediate and delayed complete pain relief was achieved in 32 (51.6%) patients and 17 (27.4%) patients, respectively; 11(17.7%) patients got significant pain relief; and 2 patients showed no response. The overall rate of complete pain relief in patients with shorter duration, typical presentation, artery compression and complete decompression was higher than that in patients with longer duration, atypical presentation, venous compression, and incomplete decompression. Conclusions Shorter duration, typical presentation, single artery compression, and complete decompression are the positive factors for better operative outcomes with microvascular decompression. Worse outcomes are usually related to venous compression, longer duration, and atypical presentation.

AB - Background Microvascular decompression has been widely used as the first choice in treating trigeminal neuralgia, but in a few patients, facial pain cannot be effectively controlled by microvascular decompression. We sought to clarify the important factors for good operative outcomes. Methods We reviewed 62 patients with trigeminal neuralgia treated by microvascular decompression during the period 2000 through 2002, including clinical presentation, operative findings, techniques, and outcomes. Neurovascular conflicts were divided into single contact, contact and indentation, single adhesion, adhesion and indentation, and trigeminal nerve atrophy. Operative outcomes were graded into immediate postoperative complete pain relief (excellent), delayed postoperative complete pain relief (better), significant pain relief (good), and no response to microvascular decompression (poor). Results All patients' presentations were typical at the time of pain onset, but the symptom in 17 patients changed to atypical before surgery. During operation, single contact and single adhesion was found in 14 patients and 15 patients, respectively; contact or adhesion in combination with indentation was found in 7 patients and 18 patients, respectively; atrophy occurred in 8 patients. Postoperatively, immediate and delayed complete pain relief was achieved in 32 (51.6%) patients and 17 (27.4%) patients, respectively; 11(17.7%) patients got significant pain relief; and 2 patients showed no response. The overall rate of complete pain relief in patients with shorter duration, typical presentation, artery compression and complete decompression was higher than that in patients with longer duration, atypical presentation, venous compression, and incomplete decompression. Conclusions Shorter duration, typical presentation, single artery compression, and complete decompression are the positive factors for better operative outcomes with microvascular decompression. Worse outcomes are usually related to venous compression, longer duration, and atypical presentation.

KW - microvascular decompression

KW - operative outcomes

KW - prognostic factors

KW - Trigeminal neuralgia

UR - http://www.scopus.com/inward/record.url?scp=7044270845&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=7044270845&partnerID=8YFLogxK

U2 - 10.1016/j.surneu.2004.02.028

DO - 10.1016/j.surneu.2004.02.028

M3 - Article

C2 - 15518843

AN - SCOPUS:7044270845

VL - 62

SP - 400

EP - 405

JO - World Neurosurgery

JF - World Neurosurgery

SN - 1878-8750

IS - 5

ER -