scholarly journals A Study on the Recurrence Rate of Trigeminal Neuralgia after MVD and the Related Factors

2019 ◽  
Vol 81 (05) ◽  
pp. 572-578
Author(s):  
Jiang-Hua Zheng ◽  
Kai Sun ◽  
Hai-Tao Zhang ◽  
Yun-Jie Xie ◽  
Ling-Xi Wang-Yang ◽  
...  
Keyword(s):  
Trigeminal Neuralgia ◽  
Recurrence Rate ◽  
Postoperative Recurrence ◽  
Female Group ◽  
Vascular Compression ◽  
Pain Group ◽  
Related Factors ◽  
Factors Affecting ◽  
The Difference ◽  
Primary Trigeminal Neuralgia

AbstractThe aim of this article is to investigate the related factors affecting the recurrence of microvascular decompression (MVD) after trigeminal neuralgia. We selected 400 cases of patients who met the diagnostic criteria of primary trigeminal neuralgia. The recurrence rate of patients and their statistical data related factors such as age, gender, disease duration, pain branches, vascular compression, patients, and complications (urban and rural), were collected. Of the 400 cases, 36 had recurrence after 2 years. In female group, the recurrence rate was (9.4%) higher than the recurrence rate in male group (8%); no recurrence rate of vascular compression group (40%) was higher than that of vascular compression group recurrence rate (8.6%); the recurrence rate of each branch in pain group from high to low was V2–3 (13.4%), V2 (12.5%), V1 (9.1%), V3 (7.5%), V1–2-3 (4.4%), V1–2 (4.3%), V1–3 (0%); and the difference was statistically significant (p < 0.05).Gender of the patient, the presence of vascular pressure, and the branch of pain could significantly affect the postoperative recurrence rate of trigeminal neuralgia in patients treated with simple MVD (p < 0.05).

scholarly journals Recurrence Rates After Microvascular Decompression in Patients With Primary Trigeminal Neuralgia and Its Influencing Factors: A Systematic Review and Meta-Analysis Based on 8,172 Surgery Patients

2021 ◽  
Vol 12 ◽  
Author(s):  
Fangyu Chen ◽  
Yuming Niu ◽  
Fan Meng ◽  
Pan Xu ◽  
Chao Zhang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Trigeminal Neuralgia ◽  
Recurrence Rate ◽  
Influencing Factors ◽  
Microvascular Decompression ◽  
Meta Analysis ◽  
Postoperative Recurrence ◽  
Recurrence Rates ◽  
Primary Trigeminal Neuralgia

Background: Primary trigeminal neuralgia (PTN) is known to reoccur following microvascular decompression (MVD) surgery. However, the rates and contributing factors related to PTN recurrence remain controversial. The purpose of this study was to explore the postoperative recurrence rates and related influencing factors of patients with PTN after MVD. Additionally, recurrence rates after different treatments were compared to provide guidelines for clinicians.Methods: We conducted systematic reviews and meta-analyses in accordance with the preferred reporting items of the PRISMA guidelines. We searched nine databases, namely, the PubMed, EMBASE, Cochrane Library, Web of Science, CINAHL, CBM, CNKI, VIP, and Wanfang databases, from establishment to July 13, 2020, selecting for studies about the long-term postoperative efficacy of MVD in the treatment of PTN. Factors associated with higher recurrence rates after MVD and long-term postoperative results of other treatments underwent formal meta-analysis, where odds ratios (ORs) with the corresponding 95% confidence intervals (CIs) were calculated. The dose-response model was used to inspect the associations between several factors and higher recurrence rates.Results: Seventy-four studies (8,172 patients, 32 case series studies, and 42 non-randomized controlled trials) were analyzed in our research. Overall, 956 out of 8,172 patients relapsed, and the pooled recurrence rate was 0.096 (0.080–0.113). Influencing factors of relatively higher recurrence rates included atypical trigeminal neuralgia symptoms, lack of nerve groove, non-arterial compression, patients who were 50–60 years old, and longer disease duration. Dose–response analysis showed that the recurrence rate had a significant trend with the published year and the follow-up time. Simultaneously, the recurrence rate of MVD treatment was much lower than that of conventional drug treatment, gamma knife surgery, percutaneous balloon compression, and radiofrequency thermocoagulation. When the surgical technique was improved or combined with partial sensory rhizotomy (PSR), the postoperative recurrence rates were significantly reduced.Conclusions: Even for PTN patients who have a successful operation, ~10% of them will still relapse. This research identifies several factors that can affect the recurrence rate. Compared with other operations, MVD has a relatively lower recurrence rate. Our analysis suggests that improved surgical techniques and combining PSR and MVD will yield better results.Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42020159276.

scholarly journals The Durability of Pain Relief Following Endoscope-Assisted Microvascular Decompression for Trigeminal Neuralgia

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Alexandra D Baker ◽  
Melvin Field
Keyword(s):  
Pain Relief ◽  
Trigeminal Neuralgia ◽  
Recurrence Rate ◽  
Microvascular Decompression ◽  
Retrospective Chart Review ◽  
Postoperative Recurrence ◽  
Pain Scale ◽  
Neurovascular Compression ◽  
Recurrence Rates

Abstract INTRODUCTION Trigeminal neuralgia (TGN) is a facial pain disorder that is paroxysmal, stabbing, and produces a shooting pain that affects the face due to the compression of the trigeminal nerve. Literature has suggested that the use of an endoscope for microvascular decompression (eMVD), as opposed to a microscope alone, is more likely to identify the source of neurovascular compression and ensure that the nerve is adequately decompressed. However, the recurrence of TGN pain continues to be an issue for patients. This project will assess the long-term success of eMVD using the reduction in Barrow Pain Scale score and recurrence rate at 1 yr. METHODS This retrospective chart review aims at exploring the efficacy of eMVD for TGN by studying rates of recurrence in a cohort of 300 patients and comparing them to the literature using descriptive statistics. This is the largest study to date evaluating postoperative recurrence for eMVD for TGN. RESULTS In this cohort, on average, patients reduced their pain scale by 2.99 units on the Barrow Pain Scale. Additionally, 95.5% of patients experienced an immediate pain relief after eMVD surgery, while only 4.3% had no improvement in TGN pain after the procedure. In this eMVD patient cohort, 22% of patients had partial recurrence of TGN pain. CONCLUSION The endoscope seems to provide long-term success for eliminating TGN pain and is at least as successful as traditional MVD. Over 95% of patients with follow-up data experienced an immediate pain relief, indicating that the efficacy of this procedure is excellent. Recurrence rates of TGN pain seem to be comparable to the existing literature on traditional MVD approaches. This cohort had a partial recurrence rate of 22%, while previous MVD studies have shown significant recurrence rates between 3% and 32%. This indicates that significant recurrence rates of TGN need to be further investigated.

Clinical Effect of Partial Sensory Root Rhizotomy on Recurrence of Multiple Sclerosing Trigeminal Neuralgia After Percutaneous Balloon Compression

2021 ◽  
Author(s):  
Yuanchao Li ◽  
Guodong Zhang ◽  
Jiaqi Zhang ◽  
Zhenguo Cheng ◽  
Yanping Lan
Keyword(s):  
Trigeminal Neuralgia ◽  
Recurrence Rate ◽  
Clinical Effect ◽  
Effective Rate ◽  
Cerebrospinal Fluid Leakage ◽  
Balloon Compression ◽  
Percutaneous Balloon ◽  
Percutaneous Balloon Compression ◽  
The Difference ◽  
Sensory Root

Abstract Objective To investigate the Clinical effect of partial sensory root rhizotomy(PSR) on recurrence of multiple sclerosing trigeminal neuralgia(TN-MS) after percutaneous balloon compression(PBC). Methods A retrospective analysis of the clinical data of 21 cases of recurrent multiple sclerosis trigeminal neuralgia after PBC who were treated with PSR in the Department of Neurosurgery of Xinxiang Central Hospital from January 2012 to July 2018; The diagnosis of MS was made by McDonald criteria, and using MRI to exclude REZ Regional blood vessels compress nerves; analysis of patients' preoperative and postoperative Visual Analogue Score (VAS), VAS 0-3 points means effective, 4 points and above means invalid or recurrence.Results Preoperative VAS: 8 -10 points in 21 cases, 1 day and 6 months after surgery VAS: 0-3 points in 21 cases, effective rate 100%; 12 months after surgery: 4 points in 2case, effective rate 95%, recurrence rate 5%; 18 months after surgery, 4 cases scored above 4, the effective rate was 81%, and the recurrence rate was 19%. The average point of VAS after PSR at 1 day, 6M, 12M, and 18M were lower than PBC, P<0.05, and the difference was statistically significant. The postoperative recurrence rate of PSR at 6M, 12M, and 18M is lower than that of PBC, P<0.05, and the difference is statistically significant. All 21 patients had facial sensation loss after surgery without major complications such as intracranial hemorrhage, facial palsy, and cerebrospinal fluid leakage. 1 case of intracranial infection. Conclusion PSR is effective in the treatment of TN-MS and can be used as a treatment for recurrence after PBC.

scholarly journals The significance of resilience in mental health promotion of marriage immigrant women: A qualitative study of factors and processes

2019 ◽  
Author(s):  
Yeonjae Jo
Keyword(s):  
Mental Health ◽  
Economic Activity ◽  
Immigrant Women ◽  
Structural Level ◽  
Public Health Services ◽  
Structured Interviews ◽  
Related Factors ◽  
Factors Affecting ◽  
The Difference ◽  
Using Data

Abstract Background: This study explores a series of processes in which marriage immigrant women achieve positive mental health status after experiencing various marriage- and migrant-related difficulties through the framework of resilience theory. As marriage immigrant women face greater barriers to public health services than non-immigrant women, it is necessary to understand the related factors, process, and context to address these barriers and strengthen available assets. Methods: Using data from semi-structured interviews, the author applied theme analysis to identify factors that affect resilience and its development process. Results: Findings indicated that the process of resilience follows enduring difficulties, collapse of stability, access to professional help, satisfaction of desire, and experience of growth. A combination of the level of spousal support, children as a driving force for change, the need for economic activity, and satisfaction of desire were identified as factors affecting the difference in growth in marriage immigrant women’s resilience. Conclusions: Spouses, children, and economic activity play key roles in resilience in positive and negative ways. The existing information barrier should be addressed at a structural level to improve the mental health of marriage immigrant women, and the optimum time for intervention is suggested within two years post-migration. Efforts to build supportive relationships with Korean spouses and meet the needs of women’s desires may also help promote these women’s resilience.

scholarly journals Factors Affecting the Degree of Angular Remodeling in Stent-Assisted Coiling of Bifurcation Aneurysms

2019 ◽  
Vol 8 (2-6) ◽  
pp. 220-230 ◽  
Author(s):  
Ahmed Saied ◽  
Nada Elsaid ◽  
Krishna Joshi ◽  
Mohamed Gomaa ◽  
Talal Amer ◽  
...  
Keyword(s):  
Carotid Bifurcation ◽  
Parent Vessel ◽  
Related Factors ◽  
Factors Affecting ◽  
Bifurcation Angle ◽  
Stent Type ◽  
Stent Length ◽  
The Difference ◽  
Coil Size

Background: Stent-assisted coiling (SAC) leads to significant changes in the vascular angle altering the bifurcation geometry and the hemodynamics at the bifurcation apex. It is believed that the stent alone exerts this effect, but other possible factors have not been studied. Purpose: To study the factors contributing to angular remodeling following SAC of bifurcation aneurysms including the anatomical, stent-related, and coil-related factors. Materials and Methods: We reviewed 43 basilar and carotid bifurcation aneurysms treated by SAC using Neuroform EZ (n = 28), Enterprise (n = 8), and Lvis Jr. (n = 7) stents. The bifurcation angle between the mother and stented daughter vessel was measured in 4 settings: pretreatment, poststenting, postcoiling, and at delayed follow-up (6–12 months). The degree of stent-induced angular remodeling was calculated by subtracting the poststenting bifurcation angle from the pretreatment one, while the coil-induced angular remodeling was calculated as the difference between the postcoiling and poststenting bifurcation angle. The immediate postprocedural degree of angular remodeling is the sum of the stent- and coil-induced angular remodeling. We studied the effect of several factors including the pretreatment bifurcation angle, aneurysm site, diameter of parent vessel, stent type, stent length in the daughter vessel, postoperative actual in situ coil size, and packing density. Results: The mean degree of stent-induced and coil-induced angular remodeling was 10.2 (0–47) and 4.53 (–7 to 30), respectively. The immediate postprocedural and delayed angular remodeling was 14.8 (–4 to 47) and 4.75 (–12 to 40), respectively. The degree of immediate remodeling was significantly affected by the actual in situ coil size (p = 0.017), and the pretreatment bifurcation angle (p = 0.024). Linear regression was carried out and the pretreatment bifurcation angle was defined as a predictor. The degree of delayed remodeling is significantly affected only by the pretreatment bifurcation angle (p = 0.011). Conclusion: Immediate angular remodeling following SAC of bifurcation aneurysms can happen after stenting or coiling or both. This is the first study reporting the role of the coils as an additional factor beside the stent in inducing immediate angular changes; this effect is correlated to the size of the coils. The pretreatment bifurcation angle is the most consistent factor affecting the degree of both immediate and delayed angular remodeling.

scholarly journals Combination of Pulsed Radiofrequency with Continuous Radiofrequency Thermocoagulation at Low Temperature Improves Efficacy and Safety in V2/V3 Primary Trigeminal Neuralgia

2018 ◽  
Vol 1 (21;1) ◽  
pp. E545-E553
Author(s):  
Guangyu Zhou
Keyword(s):  
Low Temperature ◽  
Trigeminal Neuralgia ◽  
Recurrence Rate ◽  
Total Efficiency ◽  
Pulsed Radiofrequency ◽  
Efficacy And Safety ◽  
Analog Scale ◽  
Ct Guided ◽  
Recovery Times ◽  
Primary Trigeminal Neuralgia

Background: Primary trigeminal neuralgia (TN) is a common clinical refractory neuralgia. Severe pain is experienced during episodes, severely impacting the patient’s quality of life. Long-term suffering from the disease can lead to anxiety, depression, and even suicide. The pathological processes involved in TN are complex, the mechanisms of pathogenesis are unknown, and effective treatment is lacking. Objective: This study aimed to assess the efficacy and safety of computed tomography (CT)- guided pulsed radiofrequency (PRF) combined with low-temperature continuous radiofrequency (CRF) thermocoagulation in V2/V3 primary trigeminal neuralgia. Study Design: This research used a retrospective comparative study design. Setting: The research took place at Shengjing Hospital of China Medical University. Methods: A total of 80 hospitalized patients with TN were selected between January 2014 and December 2015 and randomly assigned to 2 groups differentiated by therapeutic method: CRF (CRF group, n = 40) and PRF + CRF (PCRF group, n = 40). Radiofrequency therapy was performed under the guidance of CT. Follow-up measures assessed preoperative conditions, pain remission, complications and side effects, recovery time, and recurrence rate over the 2 years following the surgery. Results: The Visual Analog Scale (VAS) scores decreased in both groups after surgery. After one month, the decrease in the VAS score in the PCRF group was more apparent, and this difference was maintained for 2 years. The total efficiency rates in the CRF and PCRF groups were 85% and 97.5%, respectively, at 6 months, 1 year, and 2 years post-surgery. The differences in total efficiency rate of pain between the 2 groups at 6 months, 1 year, and 2 years were statistically significant. Recovery times in the PCRF group were shorter than those in the CRF group. Specifically, recovery times for facial numbness in the CRF and PCRF groups were 3.12 ± 1.21 months and 2.23 ± 1.02 months, respectively. Recovery times for masticatory muscle weakness were 4.33 ± 1.54 months and 3.42 ± 0.98 months, respectively. Limitations: This study is limited by being a retrospective study, and by having a relatively small sample size from a single center. Conclusions: CT-guided PRF combined with low-temperature CRF thermocoagulation for treating V2/V3 primary TN effectively relieves pain, increases late-stage pain remission rate, reduces complications, and reduces the rate of recurrence. Key words: Complication, continuous radiofrequency thermocoagulation, pulsed radiofrequency, recurrence rate, trigeminal neuralgia, Visual Analog Scale

Visualization of Vascular Compression of the Trigeminal Nerve With High-Resolution 3T MRI: A Prospective Study Comparing Preoperative Imaging Analysis to Surgical Findings in 40 Consecutive Patients Who Underwent Microvascular Decompression for Trigeminal Neuralgia

Neurosurgery ◽  
2011 ◽  
Vol 69 (1) ◽  
pp. 15-26 ◽  
Author(s):  
Paulo Roberto Lacerda Leal ◽  
Marc Hermier ◽  
Miguel Angelo Souza ◽  
Gerardo Cristino-Filho ◽  
Jean Claude Froment ◽  
...  
Keyword(s):  
Image Analysis ◽  
Magnetic Resonance ◽  
High Resolution ◽  
Trigeminal Neuralgia ◽  
Prospective Study ◽  
Microvascular Decompression ◽  
Preoperative Imaging ◽  
Vascular Compression ◽  
3T Mri ◽  
Primary Trigeminal Neuralgia

Abstract BACKGROUND: High-resolution three-dimensional (3D) magnetic resonance imaging (MRI) has demonstrated its ability to predict fine trigeminal neurovascular anatomy. OBJECTIVE: To address the predictive value of 3-Tesla (3T) MRI in detecting and assessing features of neurovascular compression (NVC), particularly regarding the degree of compression exerted on the root, in patients who underwent microvascular decompression (MVD) for classic primary trigeminal neuralgia. METHODS: This prospective study includes 40 consecutive patients who underwent MVD for classic primary trigeminal neuralgia. All patients underwent a preoperative 3T MRI with 3D T2-weighted driven equilibrium (DRIVE), 3D time-of-flight (TOF) magnetic resonance angiography (MRA), and 3D T1-weighted gadolinium-enhanced sequences in combination. Evaluations were performed by 2 independent observers and compared with the operative findings. RESULTS: For prediction of NVC, image analysis corresponded with surgical findings in 39 cases. Of the 3 patients in whom image analysis did not show NVC, 2 did not have NVC at the time of intraoperative observation. MRI sensitivity was 97.4% (37/38), and specificity was 100% (2/2). The kappa coefficients (κ) for predicting the offending vessel, its location, and the site of compression were 0.882, 0.813, and 0.942, respectively. Image analysis correctly defined the severity of the compression in 31 of the 37 cases. The κ coefficients predicting the degree of compression were 0.813, 0.833, and 0.852, respectively, for Grades 1 (simple contact), 2 (distortion), and 3 (marked indentation). CONCLUSION: 3T MRI using 3D T2-weighted DRIVE in combination with 3D TOF-MRA and 3D T1-weighted gadolinium-enhanced sequences proved to be reliable in detecting NVC and in predicting the degree of root compression, the outcome being correlated with the latter.

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