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    • Treatment of Recurrent Trigeminal Neuralgia after Microvascular Decompression: How to Select

    Wenming Lv, Yanyu Qin, Xiaoliang Liu,Liangwen Zhang

    JOURNAL OF CLINICAL NEUROSCIENCE（2024）

    First Peoples Hosp Ningyang Cty

    Cited 0|Views2
    Abstract
    BACKGROUND:This study aimed to investigate individualized treatment strategies and clinical outcomes in patients with recurrent trigeminal neuralgia after undergoing microvascular decompression (MVD). METHODS:One hundred forty-four patients with recurrent trigeminal neuralgia after MVD were retrospectively examined and grouped according to treatment. Surgical efficacy and pain recurrence were analyzed as outcomes. RESULTS:Repeat craniotomy was performed in 31 patients (21.5 %), percutaneous balloon compression (PBC) in 67 (46.5 %), and radiofrequency thermocoagulation (RFT) in 46 (32.0 %). Effectiveness did not differ among the three types of treatment (P = 0.052). The incidence of postoperative complications, including trigeminal nerve cardiac reflex, facial numbness, and mastication weakness, was lower in the craniotomy group than the PBC and RFT groups (P < 0.001). The 5-year pain recurrence rate was significantly higher than the 1-year rate in all groups. Although the 1-year pain recurrence rate did not differ among the groups, the 5-year rate was significantly lower in the repeat craniotomy group than the other groups (P < 0.001). CONCLUSION:Patients with recurrent trigeminal neuralgia after MVD should be treated based on imaging evaluation and general condition. Repeat craniotomy, PBC, and RFT are all effective. Incidence of postoperative complications and long-term pain recurrence-free survival are superior for repeat craniotomy.
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    Key words
    Recurrence,Trigeminal neuralgia,Craniotomy,Percutaneous balloon compression,Radiofrequency thermocoagulation
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