Standardized reporting of adverse events after microvascular decompression of cranial nerves; a population-based single-institution consecutive series.

Abstract

To investigate frequencies of adverse events occurring within 30 days after microvascular decompression (MVD) surgery using a standardized report form of adverse events. We conducted a retrospective review of 98 adult patients (≥16years) treated with MVD between 1 January 1994 and 1 June 2013. Adverse events occurring within 30days were classified according to the Landriel Ibanez classification for neurosurgical complications: grade I represents any non-life threatening complication treated without invasive procedures; grade II is complications requiring invasive management; grade III is life-threatening adverse events requiring treatment in an intensive care unit (ICU); grade IV is death as a result of complications. We sought to compare our results with reports from the literature. Patients' median age was 61years (range 26-83), and 64 (65%) were females. Indications for MVD were trigeminal neuralgia (n = 77, 79%), glossopharyngeal neuralgia (n = 4, 4%), hemifacial spasm (n = 16, 16%) and combined trigeminal neuralgia and hemifacial spasm (n = 1, 1%). The overall 30-day complication rate was 20%, with 14% grade I complications, 5% grade II complications and 1% grade III complications. The comparison with the literature was hampered by the diverse and unsystematic way of reporting complications. We provide a standardized report of postoperative complications in a consecutive patient series undergoing MVD. Due to the heterogeneous and non-standardized reporting of complications in the literature, it is difficult to know if our 20% complication rate is low or high. Standardized reporting is a necessity for meaningful and more valid comparisons across studies. The safety of MVD, a fairly standardized neurosurgical procedure, is well suited for comparisons across centers provided that complications are reported in a standardized manner.