A Review on MVD for Trigeminal Neuralgia

Renuka S. Melkundi, S. Melkundi
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Abstract

Background: Trigeminal neuralgia (TN) is a rare kind of face pain. It's characterised by a rapid onset of acute electric shock-like facial discomfort that's centred along the fifth cranial nerve's sensory distribution. Although many patients respond to medicinal treatment, when PTS symptoms become intractable and drugs are no longer effective, patients must seek surgical decompression. Our study aims to review about the correlation of vascular compression radiologically and during surgery and micro vascular decompression for trigeminal neuralgia and its outcome along with the review of literature.  Methods: It's a retrospective study that looked at 40 people who were diagnosed with TN between July 2009 and July 2015. All of the patients have undergone MVD. We looked at demographic information, clinical presentation, surgical findings, complications, and long-term follow-up. Results: The median age of onset of TN is 50.4 years, with five age groups ranging from 24 to 89 years, with a 65.5 percent female preponderance over men. The ratio of right to left in the distribution of location was 1.5:1. The study found no evidence of mortality. Three patients in the study population experienced complications. Three patients exhibited facial hyposthesia, one had V3 paresis, and one had CSF otorrhoea, all of which were resolved with LP drainage. Except for one patient who had prolonged discomfort, all of the patients improved satisfactorily.  Conclusions: To summarise, microvascular decompression (MVD) is the surgical method of choice for medically refractory TN patients who are surgically fit. MVD has the highest rate of long-term patient satisfaction and the lowest rate of pain recurrence of all the currently known surgical procedures.
MVD治疗三叉神经痛的研究进展
背景:三叉神经痛是一种罕见的面部疼痛。它的特点是快速发作的急性电击样面部不适,集中在第五脑神经的感觉分布上。尽管许多患者对药物治疗有反应,但当PTS症状变得难以治愈且药物不再有效时,患者必须寻求手术减压。我们的研究旨在回顾三叉神经痛的放射学和术中血管压迫与微血管减压的相关性及其预后,并复习文献。方法:这是一项回顾性研究,研究了2009年7月至2015年7月期间被诊断为TN的40人。所有患者均经历过MVD。我们研究了人口统计信息、临床表现、手术结果、并发症和长期随访。结果:TN发病年龄中位数为50.4岁,分为24 ~ 89岁5个年龄组,女性比男性多65.5%。位置分布的左右比例为1.5:1。研究没有发现死亡的证据。研究人群中有3名患者出现了并发症。3例患者出现面部感觉减退,1例出现V3侧瘫,1例出现脑脊液耳漏,均经LP引流解决。除1例患者持续不适外,其余患者均有满意的改善。结论:综上所述,微血管减压(MVD)是医学难治性TN患者手术适合的首选手术方法。MVD具有最高的长期患者满意度和最低的疼痛复发率的所有目前已知的外科手术。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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