Background: Several studies have suggested favorable results with endoscope-assisted microvascular decompression (EA-MVD) for treating patients with trigeminal neuralgia (TN); however, supporting evidence is limited.
Objectives: This study aimed to compare the efficacy and safety of EA-MVD with microscopic microvascular decompression (M-MVD).
Study Design: Prospective controlled study.
Setting: We performed a prospective controlled clinical study that included 52 patients with TN (36, [69.2%] women; 16, [30.8%] men), from June 2021 through January 2022.
Methods: Patients were assigned to receive either EA-MVD (n = 23) or M-MVD (n = 29). The primary outcome was pain intensity relief, measured using the Visual Analog Scale (VAS) and the Barrow Neurological Institute grading scale. The secondary outcomes were the detection of multiple offending vessels, endoscopic use, operation time, hospital stay length, and complications. All patients were followed-up for >= 12 months.
Results: At 12 months, both treatment groups showed similar improvements in pain intensity (P = 0.099). The mean VAS score was 3.5 ± 1.6 and 2.9 ± 1.7 in the EA-MVD and M-MVD groups, respectively. Overall, most patients in both groups reached a pain-free status or had nearly pain-free relief (EA-MVD: 21/23, 91.3%; M-MVD: 27/29, 93.1%). The incidence of multiple offending vessels was higher in the EA-MVD group than in the M-MVD group (52.2% vs 17.2%, P = 0.038). The mean operating time in the EA-MVD group (158 ± 27 minutes) was longer and the hospital stay (6 ± 1 days) was shorter than those of the M-MVD group (144 ± 25 minutes and 8 ± 4 days). No mortality or endoscope-related serious adverse events were noted, with the exception of an intracranial infection case in the M-MVD group.
Limitations: The mean follow-up time was relatively short and a single-center study and a small patient population, which might bring some clinical bias.
Conclusions: M-MVD and EA-MVD achieved similar analgesic effects for TN; however, EA-MVD allowed observation of more probable offending vessels with good flexible operative visualization.
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Br J Radiol
January 2025
Shenzhen University Medical School, Shenzhen University, Shenzhen, Guangdong, 518055, China.
Objective: The purpose of this study was to assess the severity of hemifacial spasm (HFS) through quantitative measures that associated it with neurovascular contact (NVC).
Methods: We enrolled 108 HFS patients (63 severe and 45 mild cases) and implemented a human-in-the-loop approach to develop a quantitative NVC feature package. This process involved using interactive segmentation on three-dimensional volumetric interpolated breath-hold examination (VIBE) MR images to delineate vascular and nerve structures.
Laeknabladid
February 2025
Department of Neurology, University Hospital of Iceland, Reykjavik, Iceland.
Trigeminal neuralgia is the most common cause of facial pain in individuals over 50 years old and can have a profoundly negative impact on quality of life. Epidemiological studies have measured the annual incidence of trigeminal neuralgia at around 4-5 cases per 100,000 inhabitants per year. In Iceland, this would amount to about 16-20 new cases annually.
View Article and Find Full Text PDFJ 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 PDFCurr 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.
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.
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