Perioperative and long-term operative outcomes after surgery for trigeminal neuralgia: microvascular decompression vs percutaneous balloon ablation.
OBJECTIVE
Numerous medical and surgical therapies have been utilized to treat the symptoms of trigeminal neuralgia (TN). This retrospective study compares patients undergoing either microvascular decompression or balloon ablation of the trigeminal ganglion and determines which produces the best long-term outcomes.


METHODS
A 10-year retrospective chart review was performed on patients who underwent microvascular decompression (MVD) or percutaneous balloon ablation (BA) surgery for TN. Demographic data, intraoperative variables, length of hospitalization and symptom improvement were assessed along with complications and recurrences of symptoms after surgery. Appropriate statistical comparisons were utilized to assess differences between the two surgical techniques.


RESULTS
MVD patients were younger but were otherwise similar to BA patients. Intraoperatively, twice as many BA patients developed bradycardia compared to MVD patients. 75% of BA patients with bradycardia had an improvement of symptoms. Hospital stay was shorter in BA patients but overall improvement of symptoms was better with MVD. Postoperative complication rates were similar (21% vs 26%) between the BA and MVD groups.


CONCLUSIONS
MVD produced better overall outcomes compared to BA and may be the procedure of choice for surgery to treat TN.
Jellish
W Scott
WS
Department of Anesthesiology, Loyola University Medical Center, Maywood, IL, USA. wjellis@lumc.edu
Benedict
William
W
Owen
Kevin
K
Anderson
Douglas
D
Fluder
Elaine
E
Shea
John F
JF
D000368:Aged; D001919:Bradycardia / Q000209:etiology; D017115:Catheter Ablation / Q000009:adverse effects*; D019299:Decompression, Surgical / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D019990:Perioperative Care; D012008:Recurrence; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014277:Trigeminal Neuralgia / Q000601:surgery*