Reoperation for recurrent trigeminal neuralgia after microvascular decompression

Liao, Jui-Jung; Cheng, Wan-Chun; Chang, Chen-Nen; Yang, Jen-Tsung; Wei, Kuo-Chen; Hsu, Yung-Hsin; Lin, Tzu‐Chieh

doi:10.1016/s0090-3019(96)00250-9

Cited by 54 publications

(28 citation statements)

References 15 publications

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“…5 42 Liao et al found that after 80 MVD procedures there were 5 cases of recurrence within 12 months. 29 Barker et al 5 examined 1185 patients who underwent an MVD for TN over a 20-year period. Patients were followed for 1 year or longer after surgery, with 91% having at least 5 years' follow-up.…”

Section: Discussionmentioning

confidence: 99%

“…A review of the literature reveals a wide range of recurrence rates of approximately 6%-41%. 5,6,8,10,11,22,23,25,[27][28][29]33,[36][37][38][39][41][42][43][44] Surgical alternatives after recurrence include repeat exploration for recurrent vascular compression and microvascular decompression (MVD), internal neurolysis, or radiofrequency lesioning. Other alternatives for recurrent TN include partial or complete sensory rhizotomy, balloon rhizotomy, glycerol injections, and radiosurgery.…”

mentioning

confidence: 99%

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Trigeminal neuralgia occurs and recurs in the absence of neurovascular compression

Lee¹,

McCartney²,

Burbidge³

et al. 2014

JNS

116

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Object Vascular compression of the trigeminal nerve is the most common factor associated with the etiology of trigeminal neuralgia (TN). Microvascular decompression (MVD) has proven to be the most successful and durable surgical approach for this disorder. However, not all patients with TN manifest unequivocal neurovascular compression (NVC). Furthermore, over time patients with an initially successful MVD manifest a relentless rate of TN recurrence. Methods The authors performed a retrospective review of cases of TN Type 1 (TN1) or Type 2 (TN2) involving patients 18 years or older who underwent evaluation (and surgery when indicated) at Oregon Health & Science University between July 2006 and February 2013. Surgical and imaging findings were correlated. Results The review identified a total of 257 patients with TN (219 with TN1 and 38 with TN2) who underwent high-resolution MRI and MR angiography with 3D reconstruction of combined images using OsiriX. Imaging data revealed that the occurrence of TN1 and TN2 without NVC was 28.8% and 18.4%, respectively. A subgroup of 184 patients underwent surgical exploration. Imaging findings were highly correlated with surgical findings, with a sensitivity of 96% for TN1 and TN2 and a specificity of 90% for TN1 and 66% for TN2. Conclusions Magnetic resonance imaging detects NVC with a high degree of sensitivity. However, despite a diagnosis of TN1 or TN2, a significant number of patients have no NVC. Trigeminal neuralgia clearly occurs and recurs in the absence of NVC.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Trigeminal neuralgia occurs and recurs in the absence of neurovascular compression

Lee¹,

McCartney²,

Burbidge³

et al. 2014

JNS

116

View full text Add to dashboard Cite

show abstract

“…The higher rates of cranial nerve deficits are reported in those conditions usually enhancing the surgical morbidity of MVD procedures, such as in the case of neurovascular conflicts difficult to correct (i.e. depending upon a megadolichobasilar artery) [20] or in case of reoperations performed to treat pain recurrence [21,[31][32][33]. Trigeminal dysesthesia occurs in 1.3%-19% of patients, while no cases of trigeminal anesthesia dolorosa have been described [10,20,21,23,29].…”

Section: Discussionmentioning

confidence: 99%

Surgical treatment of trigeminal neuralgia: results of percutaneous treatment versus microsurgical decompression

et al. 2000

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A patient with trigeminal neuralgia may need different forms of treatment during his or her lifetime. Physicians should be aware of the different available surgical treatments, and know their effectiveness, side effects and complications. Microvascular decompression is considered by many to be the most effective treatment. The goal of the procedure is to remove the cause of pain, obtained by decompressing the nerve at its entry point into the pons. Percutaneous procedures are more easily performed but the recurrence rate of pain is higher. It is difficult to compare the results of surgical procedures reported by different authors. Therefore, we compare the efficacy of 155 microvascular decompressions with 113 radiofrequency thermocoagulations and 215 percutaneous microcompressions performed by the same surgical team. Our study confirms microvascular decompression as the most effective surgical treatment, although percutaneous procedures play an important role in the treatment protocol and have to be offered to patients as a therapeutic option.

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“…The main cause of recurrence is adhesion between the implant and the adjacent neurovascular structures. 1,2,7,9) Transposition techniques have recently been used instead of interposition techniques to avoid such adhesion. The sling retraction technique is particularly recommended.…”

Section: Introductionmentioning

confidence: 99%

Complication Caused by Use of Fibrin Glue in Vessel Transposition for Trigeminal Neuralgia -Case Report-

Ohta

Komatsu

Abe

et al. 2008

Neurol. Med. Chir.(Tokyo)

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A 64-year-old man underwent microvascular decompression of the left superior cerebellar artery (SCA) for left trigeminal neuralgia (TN) using a sling of Teflon tape fixed to the tentorium with fibrin glue. The TN disappeared immediately after surgery, but recurred unusually rapidly at 2 weeks later at the same intensity as before. Second surgery revealed the SCA was suspended from the tentorium, but the trigeminal nerve was stretched and displaced superolaterally because of adhesion to the superior petrosal vein. The adhesion was thought to involve the fibrin glue used during the sling retraction procedure. The nerve was meticulously dissected from the adhesion, and the trigeminal nerve was placed in the correct position. The postoperative course was uneventful, and the TN disappeared completely. We recommend that the smallest amount of the fibrin glue possible be used to avoid adhesion to the surrounding neurovascular elements.

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Reoperation for recurrent trigeminal neuralgia after microvascular decompression

Cited by 54 publications

References 15 publications

Trigeminal neuralgia occurs and recurs in the absence of neurovascular compression

Trigeminal neuralgia occurs and recurs in the absence of neurovascular compression

Surgical treatment of trigeminal neuralgia: results of percutaneous treatment versus microsurgical decompression

Complication Caused by Use of Fibrin Glue in Vessel Transposition for Trigeminal Neuralgia -Case Report-

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