Microvascular decompression as a second step treatment for trigeminal neuralgia in patients with failed two-isocentre gamma knife radiosurgery.
Neurosurg Rev
; 45(1): 783-791, 2022 Feb.
Article
em En
| MEDLINE
| ID: mdl-34292437
ABSTRACT
OBJECTIVE:
Subsequent microvascular decompression (MVD) might be affected by the previous two-isocentre gamma knife radiosurgery (GKS) due to the tissue changes caused by its higher dose radiation and larger treatment volume. This study aimed to evaluate the safety and efficacy of MVD as a second step treatment after two-isocentre GKS.METHODS:
Between December 2016 and May 2019, data from 19 consecutive trigeminal neuralgia (TN) patients who experienced MVD after failed two-isocentre GKS were collected. The clinical characteristics, intraoperative findings, surgical outcomes and complications were reviewed and compared with 158 patients who underwent MVD as an initial treatment.RESULTS:
Fifteen patients (78.9%) achieved complete pain relief (Barrow Neurological Institute, BNI class I) immediately after surgery and nine patients (47.4%) maintained complete pain relief at the last follow-up, which was similar to patients who underwent initial MVD. The median follow-up period was 36 months. The incidence of new or worsened facial numbness showed no statistical significance between the groups. During surgery, trigeminal nerve atrophy was noted in 9 patients (47.4%), thickened arachnoid in 3 patients (15.8%), atherosclerotic plaque in 3 patients (15.8%) and neurovascular adhesion in 1 patient (5.3%).CONCLUSIONS:
MVD remains an effective and safe rescue therapy for patients who elect the minimally invasive treatment with two-isocentre GKS for the first time, without an increased risk of facial numbness.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neuralgia do Trigêmeo
/
Radiocirurgia
/
Cirurgia de Descompressão Microvascular
Limite:
Humans
Idioma:
En
Revista:
Neurosurg Rev
Ano de publicação:
2022
Tipo de documento:
Article