Influence of number of offending vessels on clinical efficacy and safety of microvascular decompression in the treatment of trigeminal neuralgia

Abstract

Objective To investigate the influence of the number of offending vessels on clinical efficacy and safety of microvascular decompression (MVD) in the treatment of trigeminal neuralgia (TN).  Methods A total of 80 idiopathic TN patients underwent MVD were divided into 2 groups: single offending vessel group (N = 48) and multiple offending vessels group (N = 32). Visual Analogue Scale (VAS) was used to evaluate the degree of pain before and after surgery. Brisman Standard was used to evaluate curative effect and calculate total effective rate. Postoperative complications (fever, angular numbness, hearing loss, transient trochlear nerve palsy, swelling of incision) and recurrence rate one year after MVD were recorded. Results The VAS scores of 2 groups after operation were significantly lower than before operation (F = 5.871, P = 0.000). There was no significant difference on VAS scores between 2 groups (F = 1.192, P = 0.318). In 48 patients of single offending vessel group, 40 cases (83.33%) were cured, 4 cases (8.33%) had obvious effect, 2 cases (4.17%) were improved and 2 cases (4.17%) had no effect. The total effective rate was 95.83% (46/48). Seven cases (14.58%) presented postoperative complications, including fever in 4 cases (8.33%), angular numbness in one case (2.08%), transient trochlear nerve palsy in 2 cases (4.17%). TN recurred in 2 cases (4.17%). In 32 patients of multiple offending vessels group, 27 cases (84.38%) were cured, 3 cases (9.38%) had obvious effect, one case (3.13%) was improved and one case (3.13% ) had no effect. The total effective rate was 96.88% (31/32). Six cases presented postoperative complications, including fever in 4 cases (12.50%), hearing loss in one case (3.13%), swelling of incision in one case (3.13%). TN recurred in 2 cases (6.25%). There were no significant differences in total effective rate (χ² = 1.863, P = 0.485), incidence of postoperative complication (χ²= 2.119, P = 0.378) and postoperative recurrence rate (adjusted χ² = 2.075, P = 0.391) between 2 groups. Conclusions MVD has similar clinical effects and safety in the treatment of TN patients with single or multiple offending vessels.

DOI: 10.3969/j.issn.1672-6731.2018.10.005