title: A retrospective study of neurocombing for the treatment of trigeminal neuralgia without neurovascular compression.
abstract: BACKGROUND
  Microvascular decompression (MVD) is the most effective and non-ablative treatment for trigeminal neuralgia (TN). However, it is not possible when neurovascular compression (NVC) is absent. Neurocombing is a possible treatment option for TN patients without NVC.
  
  
  OBJECTIVE
  To evaluate and describe the clinical outcome of neurocombing for the treatment of TN when NVC was absent.
  
  
  METHODS
  We retrospectively reviewed the clinical data of the 37 patients of Type 1 TN without NVC who underwent neurocombing in our department between January 2013 and November 2014. The Barrow Neurological Institute (BNI) Pain Intensity scale, the numerical rating scale (NRS) and the quality of life scale (QOL) were evaluated in four stages-presurgical, immediate, at 1 and at 3 years. Pain recurrence was statistically evaluated with Kaplan-Meier analysis.
  
  
  RESULTS
  All the 37 enrolled patients were proved to have no NVC by imaging or exploration in surgery. The mean follow-up duration was 29.50 months. After the procedure, 35 patients (94.6%) experienced immediate pain relief (BNI I) and 2 patients (5.4%) had occasional pain without any medication (BNI II). At 1 year and 3 years, the rates of successful pain relief (BNI I&II) were 86.5 and 83.3%, respectively. 34 patients (91.9%) suffered from mild facial numbness, while it did not exert a harmful impact on their quality of life.
  
  
  CONCLUSIONS
  This study demonstrated that neurocombing is an attractive, effective, safe and durable treatment option for TN when NVC is absent. Further study is needed to explain the complicated and exact mechanism of pain relief by neurocombing.
authors.affiliation: The Department of Neurosurgery, Hangzhou First People's Hospital, 261 Huan Sha Road, Shang Cheng District, Hangzhou, 310006, China.|Zhejiang Chinese Medical University, 548 Bin Wen Road, Bin Jiang District, Hangzhou, 310053, China.|The Department of Neurosurgery, Zhejiang Provincial Hospital of Traditional Chinese Medicine, 54 You Dian Road, Shang Cheng District, Hangzhou, 310006, China.
authors.forename: X
authors.initials: X
authors.lastname: Liang
authors.affiliation: The Department of Neurosurgery, Hangzhou First People's Hospital, 261 Huan Sha Road, Shang Cheng District, Hangzhou, 310006, China.
authors.forename: X
authors.initials: X
authors.lastname: Dong
authors.affiliation: The Department of Neurosurgery, Hangzhou First People's Hospital, 261 Huan Sha Road, Shang Cheng District, Hangzhou, 310006, China.|Zhejiang Chinese Medical University, 548 Bin Wen Road, Bin Jiang District, Hangzhou, 310053, China.
authors.forename: S
authors.initials: S
authors.lastname: Zhao
authors.affiliation: The Department of Neurosurgery, Hangzhou First People's Hospital, 261 Huan Sha Road, Shang Cheng District, Hangzhou, 310006, China.|Zhejiang Chinese Medical University, 548 Bin Wen Road, Bin Jiang District, Hangzhou, 310053, China.
authors.forename: X
authors.initials: X
authors.lastname: Ying
authors.affiliation: The Department of Neurosurgery, Hangzhou First People's Hospital, 261 Huan Sha Road, Shang Cheng District, Hangzhou, 310006, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Du
authors.affiliation: The Department of Neurosurgery, Hangzhou First People's Hospital, 261 Huan Sha Road, Shang Cheng District, Hangzhou, 310006, China. d542762345@126.com.
authors.forename: W
authors.initials: W
authors.lastname: Yu
mesh_terms: D005260:Female; D006801:Humans; D061145:Microvascular Decompression Surgery / Q000379:methods*; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D014277:Trigeminal Neuralgia / Q000473:pathology / Q000601:surgery*
keywords: Microvascular decompression; Neurocombing; Neurovascular compression; Trigeminal neuralgia