Influence of conflict vessels in efficacy of microvascular decompression for trigeminal neuralgia

Abstract

Objective To study the influence of conflict vessels of trigeminal neuralgia (TN) in microvascular decompression (MVD) efficacy. Methods The clinical data of 86 patients accepted MVD for TN, admitted to our hospital from July 2008 to August 2012, were retrospectively analyzed. According to the number of offending vessels under intranperative microscope, the patients were divided into single offending vessel group and multi-offending vessels group; the clinical features, distributions of offending vessels, imaging results and surgical findings of the two groups were compared. Results Forty-nine patients (57.0%) were enrolled to single offending vessel group, and 37 (43.0%) were enrolled to multi-offending vessels group; ratio of offside pain was higher than that of left side in both two groups. Conflict vessels in the single offending vessel group mainly were superior cerebellar artery (SCA, n=29, 59.2%) and anterior inferior cerebellar artery (AICA, n=19, 38.8%); conflict vessels in the multi-offending vessels group mainly were SCA+AICA (n=21, 56.8%) and SCA+ petrosal vein (n=8, 21.6%). Follow-up at 6 months after the operation showed an efficient outcome of 96.5%: the effective rate of single offending vessel group was 98.0% while that of multi-offending vessels group was 94.6% with significant difference(χ2=0.003, P=0.958). No mortality or severe complications, such as hearing loss, cerebellar bleeding or cerebellar infarction, were recorded. Conclusions MVD is a safe and effective treatment for TN. MVD on multiple conflict vessels TN and that on single conflict vessel TN have approximate efficacy. Key words: Trigeminal neuralgia; Microvascular decompression; Conflict vessel