TN commonly becomes refractory to medication and may require surgical intervention. There are many studies reporting successful outcomes of various procedures for TN, however, the subjective nature of pain and lack of HRQoL data make comparisons difficult. The results of this study suggest MVD is significantly more likely to produce a BNI I outcome and result in greater QOL than SRS at 7 years follow up. MVD had significantly less complications and a lower recurrence rate at 7 years. MVD success rates were inversely correlated with age.
Microvascular decompression surgery In 1967, Peter Jannetta described that freeing the trigeminal nerve of vascular contact eliminated or reduced the attacks of TN(23). Microvascular decompression is currently the most common surgical treatment for TN(24, 25). MVD procedures in the …show more content…
have increased 194%, while rhizotomies have decreased by 92% between the years of 1988 to 2008(7). While considered safe, MVD is a major neurosurgical procedure that carries some risk. The surgeon must be familiar with the anatomy of the cerebellopontine angle as the vascular compression is commonly located at the trigeminal root entry zone (TREZ)(26). Too much retraction of the brain or tearing of the petrosal veins can lead to postoperative cerebellar hemorrhage and death(27).
Many observational studies have found MVD to be an effective treatment for TN. Tatli et al(28) conducted a review of all surgical treatments for TN, including 16 studies for MVD in which the average follow up was 6.7 years. Pain free rates at last follow-up were 76.6%, and the average recurrence rate was 18.4% at last follow-up. They also found rates of facial numbness at 1-2%. Our analysis found that MVD resulted in a lower rate of BNI I outcomes (52.8% at 7 years). However, Tatli et al noted that the results of many of the observational studies
Microvascular decompression surgery In 1967, Peter Jannetta described that freeing the trigeminal nerve of vascular contact eliminated or reduced the attacks of TN(23). Microvascular decompression is currently the most common surgical treatment for TN(24, 25). MVD procedures in the …show more content…
have increased 194%, while rhizotomies have decreased by 92% between the years of 1988 to 2008(7). While considered safe, MVD is a major neurosurgical procedure that carries some risk. The surgeon must be familiar with the anatomy of the cerebellopontine angle as the vascular compression is commonly located at the trigeminal root entry zone (TREZ)(26). Too much retraction of the brain or tearing of the petrosal veins can lead to postoperative cerebellar hemorrhage and death(27).
Many observational studies have found MVD to be an effective treatment for TN. Tatli et al(28) conducted a review of all surgical treatments for TN, including 16 studies for MVD in which the average follow up was 6.7 years. Pain free rates at last follow-up were 76.6%, and the average recurrence rate was 18.4% at last follow-up. They also found rates of facial numbness at 1-2%. Our analysis found that MVD resulted in a lower rate of BNI I outcomes (52.8% at 7 years). However, Tatli et al noted that the results of many of the observational studies