Trigeminal neuralgia recurrence: a comparison of microvascular decompression and percutaneous balloon compression: a five years follow-up study

• Published in: Arquivos de neuro-psiquiatria Vol. 79; no. 1; pp. 51 - 55
• Main Authors: CHAVES, Jennyfer Paulla Galdino, DE OLIVEIRA, Tatiana Von Hertwig Fernandes, FRANCISCO, Alexandre Novick, TRINTINALHA, Mariana de Oliveira, CARVALHO, Niels Vinicius Pádua
• Format: Journal Article
• Language: English
• Published: Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil Thieme Revinter Publicações Ltda 01-01-2021; Arquivos de Neuro-Psiquiatria; Academia Brasileira de Neurologia - ABNEURO; Academia Brasileira de Neurologia (ABNEURO)
• Subjects: Balloon treatment; Brazil; Compression; Decompression; Demography; Follow-Up Studies; Humans; Intractable Pain; Male; Microsurgery; Microvascular Decompression Surgery; Microvasculature; Middle Aged; Neuralgia; NEUROSCIENCES; Pain; Patients; PSYCHIATRY; Recurrence; Retrospective Studies; Surgery; Treatment Outcome; Trigeminal nerve; Trigeminal Neuralgia; Trigeminal Neuralgia - surgery; Brazil; Dor Intratável; Cirurgia de Descompressão Microvascular; Intractable Pain; Neuralgia do Trigêmeo; Microvascular Decompression Surgery; Trigeminal Neuralgia
• ISSN: 0004-282X; 1678-4227; 1678-4227
• DOI: 10.1590/0004-282X-anp-2020-0115

ABSTRACT
Background:
About 50% of patients that suffer from trigeminal neuralgia do not experience sustained benefit from the use of oral medication. For their adequate management, a few surgical procedures are available. Of these, percutaneous balloon compression (PBC) and microvascular decompression (MD) are two of the most performed worldwide. In this retrospective study, we present the outcomes of these techniques through estimation of initial pain relief and subsequent recurrence rate.
Methods:
Thirty-seven patients with medically refractory trigeminal pain surgically treated at Hospital Cajuru, Curitiba, Brazil, with PBC, MD or both between 2013 and 2018 were enrolled into this retrospective study. The post-procedural rate for pain relief and recurrence and associations between patient demographics and outcomes were analyzed.
Results:
MD had an earlier recurrence time than balloon compression. Of the 37 patients, the mean age was 61.6 years, approximately one third were male and most had type I neuralgia. The most affected branch was the maxillary (V2). The time for recurrence after surgery was on average 11.8 months for PBC and 9.0 months for MD. Complications were seen only with microsurgery.
Conclusions:
MD presented with a more precocious recurrence of pain than PBC in this article. Moreover, it had a higher recurrence rate than described in the literature as well, which is possibly explained by the type of graft (muscle) that was used to separate the neurovascular structures.