Intraoperative prophylaxis of trigeminal neuralgia reccurence during microvascular decompression of trigeminal nerve
Abstract
Objective: to improve the results of surgical treatment of patients with Trigeminal neuralgia (TN). Material and Methods: retrospective analysis of results of microvascular decompression (MVD) in 200 patients (comparison group) with classical TN varying in age from 30 to 84 years. In this group of patients the neurovascular conflict (NVC) was corrected using a coupling shaped polypropylene protector. In addition, it was studied the results of (MVD) in 33 patients (control group) with classical TN within age from 38 to 77 years, operated with considering potential factors that could cause a recurrence of TN. Correction of (NVC) in this group of patients was corrected using coupling shaped polypropylene protector, and if necessary with the use of few protectors (type garland), and a part of patients (NVC) was correctied with use of teflon gasket or the combination of coupling shaped polypropylene protector and teflon gasket. Results: studied catamnesis of operated patients (comparison group) showed recurrence of TN in 22 (11%) patients, 16 of them women. The time of occurrence of recurrence varied from a few months to 2 years. In the patients (control group) operated with considering potential factors for recurrence of TN it happened in only 1 patient. Conclusion: MVD is an effective method of surgical treatment for TN, which can completely relieve the patient from pain. The correct choice of patient category and the restoration of normal topography-anatomic relationship of the conflicting vessel and trigeminal nerve root is one of the most important highlights in preventing recurrence of TN.
About the Authors
V. A. Baliazin
ГБОУ ВПО Ростовский государственный медицинский университет Минздравсоцразвития РФ
Russian Federation
Russian Federation
Seykhvel Salakh
ГБОУ ВПО Ростовский государственный медицинский университет Минздравсоцразвития РФ
Russian Federation
Russian Federation
References
1. Балязин В.А., Балязина Е.В. Пути уменьшения осложнений и рецидивов после микроваскулярной декомпрессии у больных с тригеминальной невралгией // Вопросы нейрохирургии - 2003. - № 2. - С. 6-10.
2. Балязин В.А., Сехвейл Салах. Интраоперационная профилактика рецидива невралгии тройничного нерва после его микроваскулярной декомпрессии. // Российский журнал боли. Материалы XVII российской научнопрактической конференции с международным участием. Ростов-на-Дону, 2-4 июня 2011 г. - С. 83.
3. Коновалов А.Н., Махмудов У.Б., Шиманский В.Н. и др. Васкулярная декомпрессия в лечении невралгии тройничного нерва. // Ж. Вопросы нейрохирургии им. Н.Н. Бурденко. - 2008. - № 3. - С. 3 - 8.
4. Мингазова Л.Р., Орлова О.Р. Нейропатические расстройства в области лица, возникшие после деструктивных операций на ветвях тройничного нерва. // Вертеброневрология: научно-практический журнал. - 2008. Том. 15. № 1 - 2. С. 54 - 55.
5. Alberione F., Arena A., Matera R. Microvascular decompression for trigeminal neuralgia: prognostic [corrected] factors // Neurocirugia. (Astur.). - 2008 Jun. - Vol. 19, № 3. - P. 242 - 247.
6. Ashkan K., Marsh H. Microvascular decompression for trigeminal neuralgia in the elderly: a review of the safety and efficacy // Neurosurgery. - 2004 Oct. - Vol. 55, № 4. - P. - 840 - 848.
7. Barker F.G.II, Jannetta P.J., Bissonette D.J. et al. The longterm outcome of microvascular decompression for trigeminal neuralgia // The New England Journal of Medicine. - 1996 Apr. - Vol. 334, № 17. - P. 1077 - 1083.
8. Bobek M.P., Sagher O. Aseptic meningitis caused by Teflon implantation for microvascular decompression: Case report // J. Neurosurg. - 1999 Jan. - Vol. 90, № 1. - P. 145 - 147.
9. Burchiel K.J. A new classification for facial pain // Neurosurgery. - 2003 Nov. - Vol. 53, № 5. - P. 1164- 1167.
10. Capelle H.H., Brandis A., Tschan C.A., Krauss J.K. Treatment of recurrent trigeminal neuralgia due to Teflon granuloma // J. Headache Pain. - 2010 Aug. - Vol. 11, № 4. - P. 339- 344.
11. Cho D.Y., Chang C.G., Wang Y.C. et al. Repeat operation in failed microvascular decompression for trigeminal neuralgia // Neurosurgery. - 1994 Oct. - Vol. 35, № 4. - P. 665- 669.
12. El-Ghandour Nasser M.F. Microvascular decompression in the treatment of trigeminal neuralgia caused by vertebrobasilar ectasia // Neurosurgery. - 2010 Aug. - Vol. 67, № 2. - P. 330-337.
13. Heros R.S. Result of microvascular decompression for trigeminal neuralgia // J. Neurosurgery. - 2009. - Vol. 110. - P. 617-619.
14. Horowitz M., Horowitz M., Ochs M. et al. Trigeminal neuralgia and glossopharyngeal neuralgia: Two orofacial pain syndromes encountered by dentists // J. Am. Dent. Assoc. - 2004. - Vol. 135. - P. 1427 - 1433.
15. Jian Hai, Shi-Ting Li, Qing-Gang Pan. Treatment of atypical trigeminal neuralgia with microvascular decompression // Neurology India. - 2006 Mar. - Vol. 54, № 1. - P. 53-56.
16. Kabatas S., Albayrak S.B., Cansever T. et al. Microvascular decompression as a surgical management for trigeminal neuralgia: a critical review of the literature // Neurol. India. - 2009 Mar. - Vol. 57, № 2. - P. 134-138.
17. Klun B. Microvascular decompression and partial sensory rhizotomy in the treatment of trigeminal neuralgia: personal experience with 220 patients // Neurosurgery. - 1992. - Vol. 30. - P. 49-52.
18. Lopez B.C., Hamlyn P.J., Zakrzewska J.M. Systematic review of ablative neurosurgical techniques for the treatment of trigeminal neuralgia // Neurosurgery. - 2004. - Vol. 54. - P. 973 - 983.
19. Mendoza N., Illingworth R.D. Trigeminal neuralgia treated by microvascular decompression: A long-term follow-up study // Br. J. Neurosurgery. - 1995. - Vol. 9. - P. 13 - 19.
20. Nannapaneni R., Satheesan K., Nath F.P. Lintene granuloma following microvascular decompression mimicking a cerebellopontine angle tumor // J. Clin. Neurosci. - 2006 Apr. - Vol. 13, № 3. - P. 380 - 383.
21. Oiwa Y., Nakai K., Takayama M. et al. Microvascular decompression of cranial nerves using sheets of a dural substitute-technical note // Neurol. Med. Chir. (Tokyo). - 2004 Feb. - Vol. 44, № 2. - P. 94 - 100.
22. Olson S., Atkinson L., Weidmann M. Microvascular decompression for trigeminal neuralgia: recurrences and complications // J. Clin. Neurosci. - 2005 Sep. - Vol. 12, № 7. - P. 787 - 789.
23. Rath S.A., Klein H.J., Richter H.P. Findings and longterm results of subsequent operations after microvascular decompression for trigeminal neuralgia // Neurosurgery. - 1996 Nov. - vol. 39, № 5. - P. 933 - 938.
24. Romansky K., Stoianchev N., Dinev E. et al. Results of treatment of trigeminal neuralgia by microvascular decompression of the Vth nerve at its root entry zone // Arch. Physiol. Biochem. - 1998 Dec. - Vol. 106, № 5. - P. 392 - 396.
25. Sandell T., Eide P.K. Effect of microvascular decompression in trigeminal neuralgia patients with or without constant pain // Neurosurgery. - 2008 Jul. - Vol. 63, № 1. - P. 93- 100.
26. Sekula R.F.Jr, Frederickson A.M., Jannetta P.J. et al. Microvascular decompression after failed Gamma Knife surgery for trigeminal neuralgia: a safe and effective rescue therapy // J. Neurosurg. - 2010 Jul. - Vol. 113, № 1. - P. 45 - 52.
27. Sindou M., Leston J.M., Decullier E. et al. Microvascular decompression for trigeminal neuralgia: the importance of a noncompressive technique-Kaplan-Meier analysis in a consecutive series of 330 patients // Neurosurgery. - 2008 Oct. - Vol. 63, № 2. - P. 5341 - 5351.
28. Smucker P., Bonnin J.M., Pritz M.B. Teflon granuloma with midbrain cysts after microvascular decompression of the trigeminal nerve. - Acta Neurochir. (Wien). - 2007. Vol. 149, № 5. - P. 537 - 539.
29. Teo C., Nakaji P., Mobbs R.J. Endosope-assisted microvascular decompression for trigeminal neuralgia: technical case report // Neurosurgery. - 2006 Oct. - Vol. 59, № 4. (Suppl. 2). - P. 489 - 490.
30. Toth G., Rubeiz H., Macdonald R.L. Polytetrafluoroethyleneinduced granuloma and brainstem cyst after microvascular decompression for trigeminal neuralgia: case report // Neurosurgery. - 2007 Oct. - Vol. 61, № 4. - P. 875 - 877.
31. Yamahata H., Tokimura H., Hanaya R. et al. Microvascular decompression for trigeminal neuralgia due to compression by the vertebral artery: report of 3 cases // Minim. Invasive Neurosurg. - 2011 Apr. Vol. 54, № 2. - P. 79 - 82.
32. Yamaki T., Hashi K., Niwa J. et al. Results of reoperation for failed microvascular decompression // Acta Neurochir. (Wien). - 1992. - Vol. 115, № 1-2. - P. 1 - 7.
33. Zakrzewska J.M., Thomas D.G. Patient's assessment of outcome after three surgical procedures for the management of trigeminal neuralgia // Acta Neurochir. (Wien) 1993. - Vol. 122, № 122. - P. 3 - 4.
Review
For citations:
Baliazin V.A., Salakh S. Intraoperative prophylaxis of trigeminal neuralgia reccurence during microvascular decompression of trigeminal nerve. Russian journal of neurosurgery. 2013;(1):47-52. (In Russ.)
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