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Category: Volume 08 Issue 05 May 2020
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Title: Effectiveness of Microvascular Decompression for Trigeminal Neuralgia: A Single Institute’s Experience with review of Literature

Authors: Dr Poonia Nemichand, MS, MCH Neurosurgery, Dr Jain Surendra, MS, MCh Neurosurgery

 DOI: https://dx.doi.org/10.18535/jmscr/v8i5.92

Abstract

 

Background: Trigeminal neuralgia (TN) is characterized by idiopathic sharp, shooting, electric shock like, episodic facial pain along the sensory distribution of the fifth cranial nerve, lasting several seconds, with pain free intervals between attacks. Although many patients respond to the medical line of treatment but when symptoms become intractable and could not tolerate the medications have to go for surgical decompression. Our study aims to review about micro vascular decompression for trigeminal neuralgia and its outcome along with the review of literature.

Methods: It is a retrospective study conducted on 54 cases who were diagnosed with TN between the period of July 2013 to December 2017. Microvascular decompression (MVD) has been performed on all the patients. Demographic data, clinical presentation, surgical findings, complications and long term follow-up were reviewed.

Results: The median age of onset of TN is 50.4 years divided into five age groups ranging from 30 to 79 years with female preponderance showing 59.25% as compared to males. The distribution of location was in the ratio of right to left was 1.7:1. There was one mortality in our study with 4 patients reporting complications, 1 patient had facial numbness,1 patient had facial palsy,1 patient had SAH and 1 patient had CSF rhinorrhoea which resolved after re-exploration of wound and mastoid cell repair. All the patients had satisfactory improvement (post-operative Barrow score of ≤3).

Conclusions: To conclude micro vascular decompression (MVD) is the surgical procedure of choice for the treatment of TN who is fit for surgery. Among the currently available surgical methods MVD provides the highest rate of long term satisfaction for the patients and offers the lowest rate of pain recurrence.

Keywords: Microvascular decompression, Trigeminal neuralgia, Facial pain.

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Corresponding Author

Dr Surendra Jain

S M S Medical College, Jaipur, India