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Efficacy and complications of microvascular decompression in patients over 70 years with trigeminal neuralgia.
Domages, Charles; Brenet, Esteban; Labrousse, Marc; Bazin, Arnaud; Chays, André; Kleiber, Jean-Charles; Dubernard, Xavier.
Afiliação
  • Domages C; Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Hospital of Reims, 45 rue Cognacq Jay, Reims, France.
  • Brenet E; Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Hospital of Reims, 45 rue Cognacq Jay, Reims, France.
  • Labrousse M; Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Hospital of Reims, 45 rue Cognacq Jay, Reims, France.
  • Bazin A; Department of Neurosurgery, Head and Neck Surgery, University Hospital of Reims, 45 rue Cognacq Jay, Reims, France.
  • Chays A; Institute of Otoneurosurgery of Champagne-Ardenne, Head and Neck Surgery, University Hospital of Reims, 45 rue Cognacq Jay, Reims, France.
  • Kleiber JC; Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Hospital of Reims, 45 rue Cognacq Jay, Reims, France.
  • Dubernard X; Institute of Otoneurosurgery of Champagne-Ardenne, Head and Neck Surgery, University Hospital of Reims, 45 rue Cognacq Jay, Reims, France.
Acta Neurol Belg ; 122(3): 615-623, 2022 Jun.
Article em En | MEDLINE | ID: mdl-35353357
ABSTRACT

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.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neuralgia do Trigêmeo / Cirurgia de Descompressão Microvascular Tipo de estudo: Etiology_studies / Observational_studies Limite: Aged / Aged80 / Humans Idioma: En Ano de publicação: 2022 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neuralgia do Trigêmeo / Cirurgia de Descompressão Microvascular Tipo de estudo: Etiology_studies / Observational_studies Limite: Aged / Aged80 / Humans Idioma: En Ano de publicação: 2022 Tipo de documento: Article