Efficacy of Microvascular Decompression in the Treatment of Trigeminal Neuralgia: A Retrospective Study of 24 Cases Outcome in a Single Center

Abstract

ABSTRACT:BACKGROUND: Vascular compression of the trigeminal nerve at its entrance into the pons is the common etiological factor in trigeminal neuralgia. Jannetta developed an operation to move the offending vessel(s) away from the nerve. This procedure is referred to as microvascular decompression because it involves an operating microscope and microsurgical technique. The area is exposed through a lateral posterior fossa craniectomy (retromastoid craniectomy), and after the vessel or vessels are separated from the nerve, a material such as a synthetic sponge or Teflon felt is inserted to maintain the separation.AIM OF THE STUDY: Searching for efficacy and complications of microvascular decompression surgery in treatment of trigeminal neuralgia.METHODS: The study included retrospective study on twenty-four patients with trigeminal neuralgia over a period from January 2016 to September 2018 at Neuroscience Hospital, Baghdad, Iraq. Preoperative evaluation with magnetic resonance imaging was applied to all patients. Pain was evaluated preoperatively and postoperatively using the Barrow Neurological Institute scale, visual analog scale and BPI-Facial scoring systems. Microscope-assisted microvascular decompression was performed using retrosigmoid craniotomy approach. The postoperative follow-up period was 6 months.RESULTS: Initial assessment to MVD patients reveals significant pain complaining with unknown etiology of TGN and normal brain MRI. They are mainly presented with significant right sided predominance and significant female gender predominance MVD patients shows significant improvement in 6 months follow-up compared with the preoperative.CONCLUSION: MVD can be offered as a line of surgical treatment for patients with TN. They are very effective method for patients with TN with immediate, better pain relief of TN.