Abstract
Objective To investigate surgical techniques of microvascular decompression (MVD) for cranial nerve disorders to further improve the efficacy and reduce the complications. Methods A retrospective study was conducted on 1 576 patients with cranial nerve disorders who underwent MVD and follow-up at Department of Neurosurgery, Affiliated Hospital of Logistics College of PAP, from April 2008 to February 2016. The 613 patients undergoing conventional MVD before December 2013 belonged to traditional surgery group. The remaining 963 patients undergoing MVD with technical modification after December 2013 were classified into modified surgery group. The modifications included employment of neurological electrophysiological monitoring, slinging of the offending vessel, multi-point decompression and et al. The effective rate and complication rate were compared post procedure between the two groups and the statistical data were analyzed. Results All 1 576 patients were followed up for 13-73 months with an average of 37.2±11.4 months. For trigeminal neuralgia, the effective rate, recurrence rate and complication rate were 92.66%(265/286), 6.30%(18/286) and 10.84%(31/286), respectively in traditional surgery group, and 96.14%, 2.83% and 5.91%, respectively in modified surgery group. For hemifacial spasm, the effective rate, recurrence rate and complication rate were 94.30%, 7.00% and 11.08%, respectively in traditional surgery group, and were 97.07%, 2.75% and 5.13%, respectively in modified group. The inter-group differences in the parameters above were statistically significant (P<0.05). Conclusions MVD is a safe and effective surgical method for the treatment of cranial nerve disorders. The application of intraoperative electrophysiology monitoring, sling retraction of the offending vessel and multi-point decompression could increase the efficacy and reduce the complications of MVD. Key words: Microvascular decompression; Cranial nerve disease; Treatment outcome; Postoperative complications
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