Endoscopic microvascular decompression versus microscopic microvascular decompression for trigeminal neuralgia: A systematic review and meta-analysis

Chen, Lulu; Shang, Yuchun; Zhang, Yesen; Zhao, Yongxuan

doi:10.1016/j.jocn.2023.09.009

Cited by 2 publications

(1 citation statement)

References 37 publications

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“…Considering the anatomical variations of the CPA, the 360 • visualization of the anatomical and topographic relationship of the compressing vessel and the trigeminal nerve root is important for the total resolution of the NVC. Intraoperative visualization of 360 • opens up with the use of an endoscope [24]. Fully endoscopic microvascular decompression was first described in 2001 by J B Eby et al [25].…”

Section: Discussionmentioning

confidence: 99%

Endoscopically Assisted Exoscopic Surgery for Microvascular Decompression of the Trigeminal Nerve with Intraoperative Use of Indocyanine Green

Sufianov,

Garifullina,

Magomedova

et al. 2024

Surgeries

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Trigeminal neuralgia (TN) is a chronic condition that is typically caused by a blood vessel exerting pressure on the V cranial nerve at the root entry zone. The gold standard for TN treatment is microvascular decompression (MVD). This illustrative case shows an advanced surgical technique that combines the use of an exoscope and endoscope to treat TN with an innovative addition of intraoperative indocyanine green (ICG) control that can improve arterial and venous compression identification. The use of exoscopes and endoscopes, offering 360° root assessment, represents a significant evolution in surgical approaches. Enhanced visualization with ICG aided in identifying complex neurovascular conflicts, improving decompression accuracy. The use of both exoscope and endoscope, offering a 360° root assessment, represents a significant evolution in the microsurgical approach of TN. The additional use of ICG monitoring in a dynamic mode may be useful in identifying the complex arteriovenous form of neurovascular conflict. The endoscopically assisted exoscopic surgery with the intraoperative use of ICG for MVD of the trigeminal nerve can improve the identification of complex impingements underlining its effectiveness and potential in neurosurgical practice.

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Section: Discussionmentioning

confidence: 99%

Endoscopically Assisted Exoscopic Surgery for Microvascular Decompression of the Trigeminal Nerve with Intraoperative Use of Indocyanine Green

Sufianov,

Garifullina,

Magomedova

et al. 2024

Surgeries

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Electroacupuncture and carbamazepine for patients with trigeminal neuralgia: a randomized, controlled, 2 × 2 factorial trial

Li,

Sun,

Luo

et al. 2024

J Neurol

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Background Trigeminal neuralgia (TN) is difficult to treat due to its severe pain intensity and recurring episodes, which significantly impact quality of life. Objectives We aimed to assess the effectiveness of electroacupuncture (EA) in alleviating the pain intensity in TN, and to determine whether EA combined with low-dosage carbamazepine (CBZ) has a synergistic effect. Methods A multi-centre, randomized, 2 × 2 factorial trial was conducted. Participants who met the inclusion criteria received active EA or sham EA for 60 min, three times a week for four weeks; CBZ (300 mg per day) or placebo for four weeks. The primary outcome was the change in visual analog scale (VAS) score from baseline to weeks 2, 4, 16, and 28. Secondary outcomes included quality of life and adverse events. Results A total of 120 participants (75 females and 45 males; mean (SD) age, 58.5 (15.3) years) were included. The main effects of EA and CBZ were significant (P < 0.001), and there was a significant interaction was identified between the interventions (P = 0.041). Participants who received EA (mean difference [MD], −0.3 [95% CI, −0.40 to −0.20] at week 2; −1.6 [−1.70 to −1.50] at week 4; −1.1 [−1.31 to −0.89] at week 16; −0.8 [−1.01 to −0.59] at week 28), CBZ (MD, −0.6 [95% CI, −0.70 to −0.50] at week 2; −0.9 [−1.03 to −0.77] at week 4, −0.2 [−0.41 to 0.01] at week 16, 0.2 [−0.01 to 0.41] at week 28), and the combination of both (MD, −1.8 [95% CI, −1.90 to −1.70] at week 2; −3.7 [−3.83 to −3.57] at week 4, −3.4 [−3.61 to −3.19] at week 16, −2.9 [−3.11 to −2.69] at week 28) had a greater reduction in VAS score over the treatment phase than their respective control groups (sham EA, placebo, and sham EA plus placebo). EA-related adverse events (6/59, 10.17%) were lower than that of CBZ (15/59, 25.42%) during the whole phases. Conclusions EA or CBZ alone are effective treatments for TN, while the combination of EA and low-dosage CBZ exerts a greater benefit. These findings in this trial demonstrate that the combination of EA and low-dosage CBZ may be clinically effective under certain circumstances. Trial registration NCT03580317.

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Endoscopic microvascular decompression versus microscopic microvascular decompression for trigeminal neuralgia: A systematic review and meta-analysis

Cited by 2 publications

References 37 publications

Endoscopically Assisted Exoscopic Surgery for Microvascular Decompression of the Trigeminal Nerve with Intraoperative Use of Indocyanine Green

Endoscopically Assisted Exoscopic Surgery for Microvascular Decompression of the Trigeminal Nerve with Intraoperative Use of Indocyanine Green

Electroacupuncture and carbamazepine for patients with trigeminal neuralgia: a randomized, controlled, 2 × 2 factorial trial

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