Abstract
ObjectivesNumerous medical and surgical therapies have been utilized to treat the symptoms of trigeminal neuralgia (TN). This retrospective study compares patients undergoing either microvascular decompression or balloon ablation of the trigeminal ganglion and determines which produces the best long-term outcomes.MethodsA 10-year retrospective chart review was performed on patients who underwent microvascular decompression (MVD) or percutaneous balloon ablation (BA) surgery for TN. Demographic data, intraoperative variables, length of hospitalization and symptom improvement were assessed along with complications and recurrences of symptoms after surgery. Appropriate statistical comparisons were utilized to assess differences between the two surgical techniques.ResultsMVD patients were younger but were otherwise similar to BA patients. Intraoperatively, twice as many BA patients developed bradycardia compared to MVD patients. 75% of BA patients with bradycardia had an improvement of symptoms. Hospital stay was shorter in BA patients but overall improvement of symptoms was better with MVD. Postoperative complication rates were similar (21% vs 26%) between the BA and MVD groups.DiscussionMVD produced better overall outcomes compared to BA and may be the procedure of choice for surgery to treat TN.
Highlights
Trigeminal Neuralgia (TN) is "a sudden brief, usually unilateral, severe, recurrent pain in the distribution of one or more branches of the fifth cranial nerve" [1]
A total of 84 patients were in the balloon ablation (BA) group, while the microvascular decompression (MVD) group had 80 patients
All MVDs were performed by one surgeon (DA), while all BAs were performed by another surgeon (JS)
Summary
Trigeminal Neuralgia (TN) is "a sudden brief, usually unilateral, severe, recurrent pain in the distribution of one or more branches of the fifth cranial nerve" [1]. This pain is typically triggered by daily activities such as eating, talking, or brushing teeth. Rare, affecting approximately 4 per 100,000 persons per year, this severe chronic pain syndrome can greatly compromise patient quality of life and disrupt daily functioning [2]. The etiology of trigeminal neuralgia in the majority of cases is compression of the nerve root by a blood vessel [3].
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