Standardized reporting of adverse events after microvascular decompression of cranial nerves; a population-based single-institution consecutive series.
To investigate frequencies of adverse events occurring within 30 days after microvascular decompression (MVD) surgery using a standardized report form of adverse events.



We conducted a retrospective review of 98 adult patients (≥16 years) treated with MVD between 1 January 1994 and 1 June 2013. Adverse events occurring within 30 days were classified according to the Landriel Ibanez classification for neurosurgical complications: grade I represents any non-life threatening complication treated without invasive procedures; grade II is complications requiring invasive management; grade III is life-threatening adverse events requiring treatment in an intensive care unit (ICU); grade IV is death as a result of complications. We sought to compare our results with reports from the literature.



Patients' median age was 61 years (range 26-83), and 64 (65 %) were females. Indications for MVD were trigeminal neuralgia (n = 77, 79 %), glossopharyngeal neuralgia (n = 4, 4 %), hemifacial spasm (n = 16, 16 %) and combined trigeminal neuralgia and hemifacial spasm (n = 1, 1 %). The overall 30-day complication rate was 20 %, with 14 % grade I complications, 5 % grade II complications and 1 % grade III complications. The comparison with the literature was hampered by the diverse and unsystematic way of reporting complications.



We provide a standardized report of postoperative complications in a consecutive patient series undergoing MVD. Due to the heterogeneous and non-standardized reporting of complications in the literature, it is difficult to know if our 20 % complication rate is low or high. Standardized reporting is a necessity for meaningful and more valid comparisons across studies. The safety of MVD, a fairly standardized neurosurgical procedure, is well suited for comparisons across centers provided that complications are reported in a standardized manner.
Department of Clinical Neuroscience, Section for Neurosurgery, Karolinska Institutet and Department of Neurosurgery, Karolinska University Hospital, Stockholm, Sweden. jiri.bartek@karolinska.se.|Department of Neurosurgery, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark. jiri.bartek@karolinska.se.
Jiri
J
Bartek
Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway.|Department of Neurosurgery, St.Olavs Hospital, Trondheim, Norway.
Sasha
S
Gulati
Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway.|Department of Neurosurgery, St.Olavs Hospital, Trondheim, Norway.
Geirmund
G
Unsgård
Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway.|Department of Neurosurgery, Stavanger University Hospital, Stavanger, Norway.
Clemens
C
Weber
Department of Clinical Neuroscience, Section for Neurosurgery, Karolinska Institutet and Department of Neurosurgery, Karolinska University Hospital, Stockholm, Sweden.
Petter
P
Förander
Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway.|Department of Neurosurgery, St.Olavs Hospital, Trondheim, Norway.
Ole
O
Solheim
Department of Neurosurgery, St.Olavs Hospital, Trondheim, Norway.|Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden.|Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Asgeir S
AS
Jakola
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D020435:Glossopharyngeal Nerve Diseases / Q000601:surgery*; D019569:Hemifacial Spasm / Q000601:surgery*; D006801:Humans; D008297:Male; D061145:Microvascular Decompression Surgery / Q000009:adverse effects*; D008875:Middle Aged; D011183:Postoperative Complications / Q000145:classification / Q000453:epidemiology*; D012015:Reference Standards; D012189:Retrospective Studies; D014277:Trigeminal Neuralgia / Q000601:surgery*
Complications; Landriel Ibanez classification; Microvascular decompression