Objective: Treatment of choice for trigeminal neuralgia (TN) by neurovascular conflict in case of failure of medical treatment is microvascular decompression (MVD). It is a safe and effective technique in the short and long term. But what about older patients who are considered more fragile anesthetically and surgically? Our Objective is to demonstrate the efficacy and complication rate of microvascular decompression (MVD) for older and younger patients with trigeminal neuralgia (TN) due to neurovascular conflict.
Methods: 102 patients with TN due to neurovascular conflict were included (June 2005-December 2016) in a single Regional hospital. 25 were included in the group composed of ≥ 70-year-old patients (G1), while 77 were included in the < 70-year-old group (G2). The patients were operated on by the same surgical team using a retro-sigmoid approach to access the neurovascular conflict. The epidemiologic, clinical, anesthetic, and surgical data were extracted.
Results: The immediate efficacy of surgical treatment (BNI pain intensity = I) was 96% in G1 and 96.10% in the G2 group (p = 0.71). At 3-year follow-up, the efficacy rate was 89% and 86%, respectively (p = 0.93). At 5 years, it was 92% and 92% (p = 0.98). Complication rates were comparable between the two groups (20% versus 27%; p = 0.47) and no deaths occurred despite the fact that G1 group had worst preoperative anesthetic score (ASA-NYHA).
Conclusion: MVD is a durable procedure in patients over 70 years of age diagnosed with essential TN. The complication rate and immediate-, medium-, and long-term efficacy were similar to those of younger patients.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s13760-022-01922-3 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Pathogenesis, Diagnosis, and Management of Trigeminal Neuralgia: A Narrative Review.
J Clin Med
January 2025
Stomatological Hospital and Dental School of Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai 200072, China.
Trigeminal neuralgia (TN) is an excruciating neurological disorder characterized by intense, stimulus-induced, and transient facial stabbing pain. The classification of TN has changed as a result of new discoveries in the last decade regarding its symptomatology, pathogenesis, and management. Because different types of facial pain have different clinical therapy and neuroimaging interpretations, a precise diagnosis is essential.
View Article and Find Full Text PDFNervus Intermedius Neuralgia.
Curr Pain Headache Rep
January 2025
Department of Neurology, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
Purpose Of Review: This review discusses the diagnosis and treatment of nervus intermedius neuralgia (NIN) and identifies gaps in the literature.
Recent Findings: The nervus intermedius is a branch of the facial nerve. NIN presents as a rare neuralgia of this nerve, causing deep ear pain, which may radiate to the auditory canal, auricle, mastoid, soft palate, temple, and angle of the jaw.
Percutaneous ballon compression, a better choice for primary trigeminal neuralgia compared to microvascular decompression?
Front Surg
January 2025
Department of Neurosurgery, Ward 2. Gansu Provincial Hospital, Lanzhou, Gansu, China.
Objective: Demonstrate the superiority of percutaneous balloon compression (PBC) in the treatment of primary trigeminal neuralgia (PTN) compared to trigeminal microvascular decompression (MVD).
Methods: Clinical data, including immediate, short-term, and long-term pain relief, complications, duration of the operation, and postoperative hospital stay, were retrospectively analyzed for 114 patients diagnosed with PTN who were treated with either PBC or MVD between January 2018 and December 2021.
Results: There were no statistically significant differences observed in the pain relief rates between the two surgical methods at 24 h postoperatively (MVD: 91.
Intravenous fosphenytoin therapy for the rescue of acute trigeminal neuralgia crisis in pre- and post-neurosurgical patients: a retrospective observational study.
Front Neurol
January 2025
Department of Neurosurgery, Nakamura Memorial Hospital, Sapporo, Japan.
Background: There is no established treatment for the acute exacerbation of trigeminal neuralgia. We aimed to investigate the efficacy and safety of intravenous fosphenytoin for this disease.
Methods: We conducted a retrospective observational study of data from 41 patients with trigeminal neuralgia who received intravenous fosphenytoin therapy.
Methods for tissue perfusion assessment after Dellon decompression of tarsal tunnels in diabetic neuropathy: key to effective management-a narrative review.
Quant Imaging Med Surg
January 2025
Division of Plastic Surgery, Johns Hopkins University, Baltimore, MD, USA.
Background And Objective: Diabetic neuropathy significantly elevates the risk of foot ulceration and lower-limb amputation, underscoring the need for precise assessment of tissue perfusion to optimize management. This narrative review explores the intricate relationship between sympathetic nerves and tissue perfusion in diabetic neuropathy, highlighting the important role of autonomic neuropathy in blood flow dynamics and subsequent compromises in tissue perfusion. The consequences extend to the development of diabetic peripheral neuropathy and related foot complications.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!