Endoscopic Vascular Decompression

Artz, Gregory J.; Hux, Frank; LaRouere, Michael J.; Bojrab, Dennis I.; Babu, Seilesh; Pieper, Daniel R.

doi:10.1097/mao.0b013e318184601a

Cited by 37 publications

(30 citation statements)

References 17 publications

(24 reference statements)

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“…2,7,11,21,24 All report excellent safety and short-to medium-term functional results. The largest of these, by Kabil et al, reported results for 255 patients with a favorable 3-year success rate and a lower rate of complications when compared with published series of microscopic MVD.…”

Section: Discussionmentioning

confidence: 99%

Fully endoscopic microvascular decompression for trigeminal neuralgia: technique review and early outcomes

Bohman

Pierce²,

Stephen³

et al. 2014

FOC

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Object Fully endoscopicmicrovascular decompression (E-MVD) of the trigeminal nerve was initially described more than 1 decade ago, but has not yet gained wide acceptance. The authors present the experience of their first 47 consecutive E-MVDs for trigeminal neuralgia (TN). Methods All surgeries were performed by a single surgeon (J.Y.K.L.) at the Pennsylvania Hospital at the University of Pennsylvania. Patients prospectively completed pain scales before and after surgery by using the Brief Pain Inventory–Facial outcomes tool. All patients were called on the telephone, and the same outcome tool was administered without reference to their preoperative pain status. Results Forty-seven patients (17 men) were identified and enrolled. Forty (85%) had Burchiel Type 1 TN. Vascular compression was observed at surgery in 42 patients (89%). No surgery was aborted or converted to microscope. One patient suffered permanent hearing loss, for a permanent neurological morbidity rate of 2%. Overall improvement in pain outcomes was excellent, with a median maximum pain intensity preoperatively of 10 and postoperatively of 0 (p< 0.0001). The mean interference with global function scores were 6.2 preoperatively and reduced to 1.0 at last follow-up (p < 0.0001). The mean interference with facial function was 7.3 preoperatively and reduced to 1.2 at last follow-up (p < 0.0001). The mean follow-up period after surgery was 15 ± 8 months. Conclusions In experienced hands, E-MVD offers superb visualization and illumination and is both safe and effective, at least in the short term. Further longer-term study is needed to compare E-MVD to traditional microscopic MVD.

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Section: Discussionmentioning

confidence: 99%

Fully endoscopic microvascular decompression for trigeminal neuralgia: technique review and early outcomes

Bohman

Pierce²,

Stephen³

et al. 2014

FOC

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“…For the most part, better surgical outcome is attributed to an increased identification of neurovascular conflicts during surgery. On the other hand, many authors find similar surgical outcome with and without the aid of the endoscope, or do not compare their results to outcomes of conventional MVDs [10,27].…”

Section: Symptom Reliefmentioning

confidence: 93%

“…Hence, we could not delineate to what extent symptoms such as facial numbness, dizziness, hearing impairment, and tinnitus, were present prior to surgery, and to what extent it was aggravated by MVD. Many authors advocate the use of eaMVD or pure endoscopic vascular decompression on the basis of lower incidence of complications [6,17,[27][28][29], but others do not find a decline in the complication rates due to the inclusion of the endoscope [8,10].…”

Section: Complication Profilementioning

confidence: 98%

Usefulness of the endoscope in microvascular decompression for trigeminal neuralgia and MRI-based prediction of the need for endoscopy

2014

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“…The applications of the neuroendoscope are quickly escalating in neurosurgery and otological surgery, so it is vital that optimal surgical techniques are used. The expanding literature on endoscopic MVD supports the use of the endoscope as a tool that provides excellent results with a low rate of complications [6,7,8]. …”

Section: Resultsmentioning

confidence: 99%

“…endoscope-assisted microsurgery [5]. We hypothesized that a fully endoscopic procedure would provide an unobstructed panoramic view of the CPA [6,7,8], allowing for a less traumatic, minimally invasive approach to the site of vascular pathology [7,9]. …”

Section: Introductionmentioning

confidence: 99%

Endoscopic Microvascular Decompression: A Stepwise Operative Technique

Lang

Chen²,

Lee³

2012

ORL

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Background/Aims: Microvascular decompression (MVD) of the trigeminal nerve is a widely accepted treatment for patients with trigeminal neuralgia caused by vascular compression. The neuroendoscope is rapidly becoming a complementary tool in minimally invasive neurosurgery of the ventral anterior skull base. Its adoption in the lateral approach to the posterior fossa has been slower and has been used primarily as an adjunct to conventional microscopic surgical techniques, e.g. endoscope-assisted microsurgery. Methods: In this paper, we describe a stepwise, technical commentary on a purely endoscopic MVD of the trigeminal nerve via the retrosigmoid route. Results: From our experience, the endoscope provides excellent visualization of the neurovascular relationship. By allowing full visualization of the trigeminal nerve, endoscopy may likely lead to an increase in the number of successful MVDs and a decrease in the number of complications. Conclusion: We believe endoscopic MVD is a safe and effective method of accessing the trigeminal nerve in the cerebellopontine angle and of performing MVD. This endoscopic technique can be implemented in other neurosurgical and neuro-otological procedures such as resection of cerebellopontine angle masses.

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Endoscopic Vascular Decompression

Abstract: Endoscopic vascular decompression for patients with vascular compressive syndromes such as TGN and HFS is a safe and equally effective procedure when compared with the traditional and widely successful MVD surgery, with the added benefit of less morbidity and shorter hospital stays.

Cited by 37 publications

References 17 publications

Fully endoscopic microvascular decompression for trigeminal neuralgia: technique review and early outcomes

Fully endoscopic microvascular decompression for trigeminal neuralgia: technique review and early outcomes

Usefulness of the endoscope in microvascular decompression for trigeminal neuralgia and MRI-based prediction of the need for endoscopy

Endoscopic Microvascular Decompression: A Stepwise Operative Technique

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