Endoscopic microvascular decompression versus microscopic microvascular decompression for trigeminal neuralgia: A systematic review and meta-analysis

Abstract

BackgroundTo compare the efficacy and safety of full endoscopic or endoscope-assisted microvascular decompression (E-MVD) and microscopic microvascular decompression (M-MVD) for primary trigeminal neuralgia (TN). MethodsWe systematically searched the online database, including PubMed, Embase and Cochrane Library. The search terms used included, but were not limited to, “Trigeminal Neuralgia”, “Microvascular Decompression Surgery” and “Endoscope”. Postoperative facial pain relief and postoperative complications were considered for meta-analysis. All the outcomes were calculated as odds ratios (ORs) with 95% confidence intervals using R language. ResultsA total of three studies involving 442 (E-MVD [218] versus M-MVD [224]) patients were included for analysis in our study. Postoperative facial pain relief (very much improved or much improved) was no difference between the two groups (OR, 0.95;95% CI, 0.57–1.58; I2 = 0%; p = 0.83). In addition, the occurrence of some postoperative complications was not statistically different between the two groups, including CSFleak (OR, 1.35;95% CI, 0.16–11.13; I2 = 0%; p = 0.94), facial paralysis (OR, 0.26;95% CI, 0.03–2.54; I2 = 0%; p = 0.67), hearing loss (OR, 0.87;95% CI, 0.30–2.55; I2 = 32%; p = 0.22), facial numbness (OR, 1.03;95% CI, 0.56–1.87; I2 = 62%; p = 0.10). ConclusionsBoth endoscopic microvascular decompression and microscopic microvascular decompression for trigeminal neuralgia appear to provide patients with equivalent facial pain relief outcomes. Complication rates were also similar between the groups.