Abstract
Objective Although microvascular decompression (MVD) has been widely accepted as an effective
treatment of trigeminal neuralgia (TN), some patients have not been cured. To improve
the postoperative outcome, the surgical procedure should be further refined.
Design This is a retrospective study.
Setting Present study conducted at a cranial nerve disorder center.
Participants Clinical data were collected from patients with TN who had undergone surgery in our
center, including 685 who had undergone traditional MVD and 576 who had undergone
the “MVD plus” procedure, in which any vessel attached to the trigeminal nerve was
freed away (“nerve-combing”), which was followed by intraoperative neurolysis.
Main Outcome Measures Postoperative outcomes and complications in the two groups were compared.
Results Among patients who underwent traditional MVD, the rates of immediate relief and 1-year
relief were 89.9 and 86.9%, respectively; among patients who underwent MVD plus group,
these rates were 95.1 and 94.6%, respectively (p = 0.05). Patients who underwent MVD plus initially exhibited a higher rate of facial
numbness (p < 0.05), but this finding decreased over time and reached the same level as that
in the traditional MVD group within 3 months (p > 0.05).
Conclusion Sufficient MVD with nerve-combing for the treatment of TN may produce a high rate
of cure with less recurrence.
Keywords
microvascular decompression - trigeminal neuralgia - nerve-combing - surgical strategy
