Current issues of trigeminal neuralgias of compressive origin. Results of surgical treatment regarding the iatrogenias influence
DOI:
https://doi.org/10.25305/unj.108684Keywords:
trigeminal neuralgia, prosopalgia, microvascular decompressionAbstract
Objective. To study the results of surgical treatment of classical and symptomatic trigeminal prosopalgias of compressive origin; to define the influence of iatrogenias and thus to improve the treatment provided for this cohort of patients.
Materials and methods. Retrospective case series assay of 43 patients with trigeminal neuralgia of compressive origin was performed. The groups were formed regarding the sequence of treatment procedures. Group 1 included 15 patients with TN (3 patients with symptomatic TN and 12 persons with classic TN) who had undergone trigeminal nerve decompression as a primary measure. Group 2 consisted of 28 patients with TN (5 symptomatic and 23 classic) operated after destructive procedures performed previously.
Results. Treatment outcomes were significantly worse in the 2nd group where destructive procedures were primary treatment options. Mean BNI PS on the 1st postoperative day were 1.2 vs 2.2 for groups 1 and 2, respectively (Р=0.01; 95% CI 0.25–1.78). At one-year of follow-up period the parameters were 1.13 vs 2.43 (P=0.0006; 95% CI 0.59–2). Average BNI NS score after one year was significantly worse in group 2 — 2.43 vs 1.27 in group 1 (P < 0.0001; 95% CI 0.67–1.65). 100% of group 2 and only 27% of group 1 had clinically significant neuropathy at one-year follow-up period after surgery with RR=3.75 (P=0.002; 95% CI 1.62–8.68).
Conclusions. We suggest that destructive procedures as a primary measure for treatment of trigeminal neuralgias of compressive origin lead to worse long-term outcomes and reduce effectiveness of reconstructive technique of microsurgical decompression option.
References
1. Love S, Coakham HB. Trigeminal neuralgia: pathology and pathogenesis. Brain. 2001 Dec;124(Pt 12):2347-60. Review. Erratum in: Brain 2002 Mar;125(Pt 3):687. [PubMed]
2. Cruccu G, Finnerup NB, Jensen TS, Scholz J, Sindou M, Svensson P, Treede RD, Zakrzewska JM, Nurmikko T. Trigeminal neuralgia: New classification and diagnostic grading for practice and research. Neurology. 2016 Jul 12;87(2):220-8. [CrossRef] [PubMed] [PubMed Central]
3. Haller S, Etienne L, Kцvari E, Varoquaux AD, Urbach H, Becker M. Imaging of Neurovascular Compression Syndromes: Trigeminal Neuralgia, Hemifacial Spasm, Vestibular Paroxysmia, and Glossopharyngeal Neuralgia. AJNR Am J Neuroradiol. 2016 Aug;37(8):1384-92. [CrossRef] [PubMed]
4. Singh MK, Egan RA. Trigeminal Neuralgia: Practice Essentials, Background, Anatomy [Internet]. Emedicine.medscape.com; 1994-2017. [cited 2017 August 17]. Available from: https://emedicine.medscape.com/article/1145144-overview#a6
5. Kumar S, Rastogi S, Kumar S, Mahendra P, Bansal M, Chandra L. Pain in trigeminal neuralgia: neurophysiology and measurement: a comprehensive review. J Med Life. 2013;6(4):383-8. [PubMed] [PubMed Central]
6. Yong RJ, Nguyen M, Nelson E, Urman RD. Pain Medicine: An Essential Review. Springer; 2017.
7. Tanaka T, Morimoto Y, Shiiba S, Sakamoto E, Kito S, Matsufuji Y, Nakanishi O, Ohba T. Utility of magnetic resonance cisternography using three-dimensional fast asymmetric spin-echo sequences with multiplanar reconstruction: the evaluation of sites of neurovascular compression of the trigeminal nerve. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005;100(2):215-25. [CrossRef] [PubMed]
8. Satoh T, Onoda K, Date I. Trigeminal Neuralgia: Diagnosis Using 3-D Magnetic Resonance Multi-Fusion Imaging. In: Hayat MA, editor. Tumors of the Central Nervous System. V. 4. Springer; 2012. P.199-209.
9. Headache Classification Subcommittee of the International Headache S. The International Classification of Headache Disorders: 2nd edition. Cephalalgia. 2004;24 Suppl 1:9-160. [PubMed]
10. Headache Classification Committee of the International Headache S. The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia. 2013;33(9):629-808. [CrossRef] [PubMed]
11. Levin M. The International Classification of Headache Disorders, 3rd Edition (ICHD III) - Changes and Challenges. Headache. 2013;53(8):1383-95. [CrossRef] [PubMed]
12. Tash RR, Sze G, Leslie DR. Trigeminal neuralgia: MR imaging features. Radiology. 1989;172(3):767-70. [CrossRef] [PubMed]
13. Tenser RB. Trigeminal neuralgia: mechanisms of treatment. Neurology. 1998;51(1):17-9. [PubMed]
14. Viana M, Tassorelli C, Allena M, Nappi G, Sjaastad O, Antonaci F. Diagnostic and therapeutic errors in trigeminal autonomic cephalalgias and hemicrania continua: a systematic review. J Headache Pain. 2013;14:14. [CrossRef] [PubMed] [PubMed Central]
15. Neff BA, Carlson ML, O’Byrne MM, Van Gompel JJ, Driscoll CLW, Link MJ. Trigeminal neuralgia and neuropathy in large sporadic vestibular schwannomas. J Neurosurg. 2017;127(5):992-9. [CrossRef] [PubMed]
16. Mathew PG, Garza I. Headache. Semin Neurol. 2011;31(1):5-17. [CrossRef] [PubMed]
17. Henschke N, Kamper SJ, Maher CG. The epidemiology and economic consequences of pain. Mayo Clin Proc. 2015;90(1):139-47. [CrossRef] [PubMed]
18. Clinical protocols for patients requiring neurosurgical care (except for traumatic brain injury. Ukrainian Neurosurgical Journal. 2008;(3):9-132. Ukrainian. [Abstract/Full Text]
19. Naraghi R, Hastreiter P, Tomandl B, Bonk A, Huk W, Fahlbusch R. Three-dimensional visualization of neurovascular relationships in the posterior fossa: technique and clinical application. J Neurosurg. 2004;100(6):1025-35. [CrossRef] [PubMed]
20. Kanal E, Maravilla K, Rowley HA. Gadolinium contrast agents for CNS imaging: current concepts and clinical evidence. AJNR American journal of neuroradiology. 2014;35(12):2215-26. [CrossRef] [PubMed]
21. Hughes MA, Frederickson AM, Branstetter BF, Zhu X, Sekula RF, Jr. MRI of the Trigeminal Nerve in Patients With Trigeminal Neuralgia Secondary to Vascular Compression. AJR Am J Roentgenol. 2016;206(3):595-600. [CrossRef] [PubMed]
22. Muzio B. Trigeminal neuralgia [Internet]. Radiopaedia.org; 2005-2017. [cited 2017 August 24]. Available from: https://radiopaedia.org/articles/trigeminal-neuralgia
23. Muzio B. Trigeminal neuralgia protocol (MRI) [Internet]. Radiopaedia.org; 2005-2017. [cited 2017 August 24]. Available from: https://radiopaedia.org/articles/trigeminal-neuralgia-protocol-mri
24. Grimmer-Somers K, Vipond N, Kumar S, Hall G. A review and critique of assessment instruments for patients with persistent pain. J Pain Res. 2009;2:21-47. [PubMed] [PubMed Central]
25. Chen HI, Lee JY. The measurement of pain in patients with trigeminal neuralgia. Clin Neurosurg. 2010;57:129-33. [PubMed]
26. McLaughlin MR, Jannetta PJ, Clyde BL, Subach BR, Comey CH, Resnick DK. Microvascular decompression of cranial nerves: lessons learned after 4400 operations. J Neurosurg. 1999;90(1):1-8. [CrossRef] [PubMed]
27. Rappaport ZH. [Microvascular decompression in trigeminal neuralgia]. Harefuah. 1996 Apr 15;130(8):515-6, 584. Hebrew. [PubMed]
28. Algorithms of statistical analysis [Internet]. Medstatistic.ru; 2013 [cited 2018 January 09]. Russian. Available from: http://medstatistic.ru/algoritm.html
29. Schoonjans F. Comparison of means calculator [Internet]. MedCalc; 2017 [cited 2018 January 09]. Available from: https://www.medcalc.org/calc/comparison_of_means.php
30. [On Amendments to the Order of the Ministry of Health of Ukraine dated September 28, 2012 No. 751] [Internet]. Legislation of Ukraine; 1994-2018 [cited 2018 January 09]. Ukrainian. Available from: http://zakon.rada.gov.ua/go/z0530-17
31. Pamir MN, Peker S. Microvascular decompression for trigeminal neuralgia: a long-term follow-up study. Minim Invasive Neurosurg. 2006;49(6):342-6. [CrossRef] [PubMed]
32. Kabatas S, Karasu A, Civelek E, Sabanci AP, Hepgul KT, Teng YD. Microvascular decompression as a surgical management for trigeminal neuralgia: long-term follow-up and review of the literature. Neurosurg Rev. 2009;32(1):87-93; discussion -4. [CrossRef] [PubMed]
33. Zihang Xie LC, Yan Wang, Zhiqiang Cui, Shijie Wang, Qiang Ao, Yuqi Zhang, Huancong Zuo. Comparison of different microsurgery methods for trigeminal neuralgia. Translational Neuroscience and Clinics. 2016;2:183-7. [CrossRef]
34. Cheng J, Liu W, Hui X, Lei D, Zhang H. Microvascular decompression for trigeminal neuralgia in patients with failed gamma knife surgery: Analysis of efficacy and safety. Clin Neurol Neurosurg. 2017;161:88-92. [CrossRef] [PubMed]
35. Theodros D, Rory Goodwin C, Bender MT, Zhou X, Garzon-Muvdi T, De la Garza-Ramos R, Abu-Bonsrah N, Mathios D, Blitz AM, Olivi A, Carson B, Bettegowda C, Lim M. Efficacy of primary microvascular decompression versus subsequent microvascular decompression for trigeminal neuralgia. J Neurosurg. 2017;126(5):1691-7. [CrossRef] [PubMed]
36. Oesman C, Mooij JJ. Long-term follow-up of microvascular decompression for trigeminal neuralgia. Skull Base. 2011;21(5):313-22. [CrossRef] [PubMed] [PubMed Central]
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2018 Andrii G. Naboichenko, Volodymyr O. Fedirko
This work is licensed under a Creative Commons Attribution 4.0 International License.
Ukrainian Neurosurgical Journal abides by the CREATIVE COMMONS copyright rights and permissions for open access journals.
Authors, who are published in this Journal, agree to the following conditions:
1. The authors reserve the right to authorship of the work and pass the first publication right of this work to the Journal under the terms of Creative Commons Attribution License, which allows others to freely distribute the published research with the obligatory reference to the authors of the original work and the first publication of the work in this Journal.
2. The authors have the right to conclude separate supplement agreements that relate to non-exclusive work distribution in the form of which it has been published by the Journal (for example, to upload the work to the online storage of the Journal or publish it as part of a monograph), provided that the reference to the first publication of the work in this Journal is included.
