Surgical Results of Microvascular Decompression Procedures and Patient's Postoperative Quality of Life: Review of 139 Cases

Abstract

Microvascular decompression (MVD) is effective for the relief of symptoms, but little is known about the impact of the MVD procedure on patient's quality of life (QoL) or which QoL factors are important. The surgical results of MVD and the impact of this procedure were evaluated on patient's QoL in 139 patients, 74 with hemifacial spasm (HFS) and 65 with trigeminal neuralgia (TN), who underwent MVD between 2004 and 2011 using the 36-Item Short Form Health Survey questionnaire. Symptoms had resolved in approximately 95% of patients after MVD. The QoL questionnaire was completed by 54 HFS patients and 38 TN patients. Although long-term QoL scores for both groups were comparable to the average national value, scores related to physical role, emotional role, and social function were significantly lower for patients within 12 months of receiving MVD for HFS, compared with the reference scores. Symptomatic improvements and complications were correlated with the QoL scores related to the social function domain for patients with HFS. No other significant relationships were observed between any of the factors or scores in any of the respective domains or periods. Subjective symptoms were the main self-reported causes of delayed recovery of QoL domains. Some QoL domains take a long time to recover and postoperative subjective symptoms might be major causes in addition to delayed relief of symptoms.

Efficacy of primary microvascular decompression versus subsequent microvascular decompression for trigeminal neuralgia

“…30 As mentioned, the rate of initial pain relief after MVD has been shown to vary from 70% to 100% in patients treated for TN. 1,4,8,12,16,18,29,31,32,34,38 In the largest series, Barker et al reported the results of 1204 MVDs with immediate, 1-year, and 10-year complete pain relief achieved in 82%, 80%, and 70% of procedures, respectively. 4 Sindou et al reported that 73.3% of patients were free of pain at 15 years.…”

“…16 Initial pain relief outcomes for patients undergoing MVD are excellent, ranging from 70% to 100% in multiple studies. 1,4,8,12,16,18,29,31,32,34,38 TN patients commonly undergo multiple less invasive treatment options prior to MVD, but the effect of these prior surgical treatments on the efficacy of subsequent MVD has not been elucidated. Furthermore, few studies have compared the efficacy of MVD performed as first-line surgical intervention to MVD performed as a subsequent surgical intervention, nor has there been examination of factors associated with multiple interventions prior to MVD that predict outcomes.…”

Thin‐slice T2 MRI imaging predicts vascular pathology in hemifacial spasm: A case‐control study

“…V C 2014 International Parkinson and Movement Disorder Society Key W ords: hemifacial spasm; microvascular decompression; MRI; botulinum toxin; facial nerve Characterized by unilateral hyperactivity of the facial nerve, hemifacial spasm (HFS) can severely reduce a patient's quality of life. [1][2][3][4] Microvascular decompression (MVD), which has been shown to be the most effective therapy for HFS, treats the disease cause by eliminating neurovascular compression. 5,6 The development of higher-resolution magnetic resonance imaging (MRI) pulse sequences and cranial nerve-specific image processing techniques has led to an increased interest in preoperative MRI as a means to detect neurovascular compression.…”

Quality of life in chronic trigeminal neuralgia patients

“…It is suggested that the recovery of a surgery may be influenced by QL factors. TN patients who underwent microvascular decompression (MVD) took almost a year to recover from social and emotional limitations 13 . A short form of this same questionnaire, SF-36 was used to evaluate the long term effect of Gamma Knife Surgery in TN patients.…”