Fully Endoscopic Microvascular Decompression for Trigeminal Neuralgia:Technical Note Describing a Single-Center Experience
Background: Microscopic microvascular decompression (MVD) of the trigeminal nerve is the gold standard surgical treatment for medically refractory classical trigeminal neuralgia. Endoscopy has significantly advanced surgery and provides enhanced visualization of the cerebellopontine angle and its cr...
Published in: | World Neurosurgery |
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Online Access: | https://kclpure.kcl.ac.uk/portal/en/publications/e5900deb-1c67-4ba9-9b22-b8af2f322158 https://doi.org/10.1016/j.wneu.2022.07.014 http://www.scopus.com/inward/record.url?scp=85136536960&partnerID=8YFLogxK |
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ftkingscollondon:oai:kclpure.kcl.ac.uk:publications/e5900deb-1c67-4ba9-9b22-b8af2f322158 2024-04-21T08:10:37+00:00 Fully Endoscopic Microvascular Decompression for Trigeminal Neuralgia:Technical Note Describing a Single-Center Experience Pak, Ho Lim Lambru, Giorgio Okasha, Mohamed Maratos, Eleni Thomas, Nicholas Shapey, Jonathan Barazi, Sinan 2022-10 https://kclpure.kcl.ac.uk/portal/en/publications/e5900deb-1c67-4ba9-9b22-b8af2f322158 https://doi.org/10.1016/j.wneu.2022.07.014 http://www.scopus.com/inward/record.url?scp=85136536960&partnerID=8YFLogxK eng eng info:eu-repo/semantics/openAccess Pak , H L , Lambru , G , Okasha , M , Maratos , E , Thomas , N , Shapey , J & Barazi , S 2022 , ' Fully Endoscopic Microvascular Decompression for Trigeminal Neuralgia : Technical Note Describing a Single-Center Experience ' , World Neurosurgery , vol. 166 , pp. 159-167 . https://doi.org/10.1016/j.wneu.2022.07.014 Endoscopic skull base surgery Microvascular decompression Trigeminal nerve Trigeminal neuralgia article 2022 ftkingscollondon https://doi.org/10.1016/j.wneu.2022.07.014 2024-03-27T15:30:55Z Background: Microscopic microvascular decompression (MVD) of the trigeminal nerve is the gold standard surgical treatment for medically refractory classical trigeminal neuralgia. Endoscopy has significantly advanced surgery and provides enhanced visualization of the cerebellopontine angle and its critical neurovascular structures. We present our initial experience of fully endoscopic microvascular decompression (e-MVD). Methods: This retrospective case series investigated e-MVD performed from September 2016 to February 2020 at a single institution. Clinical data including presenting symptoms, medications, operative findings, postoperative complications, and outcomes were recorded. The 5-point Barrow Neurological Institute (BNI) pain intensity score was used to quantify patients’ pain relief. Results: During the study period, 25 patients with trigeminal neuralgia (10 males, 15 females; mean [SD] age = 63 [10.4] years) underwent e-MVD. All patients had a preoperative BNI score of V. The left side was affected in 15 patients. Complications occurred in 2 patients: both experienced hearing loss, and one experienced transient facial weakness 7 days after surgery. The facial weakness had resolved by the last follow-up. All patients were completely pain-free (BNI score I) immediately postoperatively. On latest follow-up, 22 patients have remained pain-free, and 3 patients have recurrent pain that is being controlled with medication (BNI score III). Conclusions: Our study demonstrated that e-MVD is a safe, possibly effective method of performing MVD with the added benefit of improved visualization of the operative field for the operating surgeon and the surgical team. Larger prospective studies are required to evaluate whether performing e-MVD confers any additional benefits in long-term clinical outcome of patients with trigeminal neuralgia. Article in Journal/Newspaper Point Barrow King's College, London: Research Portal World Neurosurgery 166 159 167 |
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King's College, London: Research Portal |
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Endoscopic skull base surgery Microvascular decompression Trigeminal nerve Trigeminal neuralgia |
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Endoscopic skull base surgery Microvascular decompression Trigeminal nerve Trigeminal neuralgia Pak, Ho Lim Lambru, Giorgio Okasha, Mohamed Maratos, Eleni Thomas, Nicholas Shapey, Jonathan Barazi, Sinan Fully Endoscopic Microvascular Decompression for Trigeminal Neuralgia:Technical Note Describing a Single-Center Experience |
topic_facet |
Endoscopic skull base surgery Microvascular decompression Trigeminal nerve Trigeminal neuralgia |
description |
Background: Microscopic microvascular decompression (MVD) of the trigeminal nerve is the gold standard surgical treatment for medically refractory classical trigeminal neuralgia. Endoscopy has significantly advanced surgery and provides enhanced visualization of the cerebellopontine angle and its critical neurovascular structures. We present our initial experience of fully endoscopic microvascular decompression (e-MVD). Methods: This retrospective case series investigated e-MVD performed from September 2016 to February 2020 at a single institution. Clinical data including presenting symptoms, medications, operative findings, postoperative complications, and outcomes were recorded. The 5-point Barrow Neurological Institute (BNI) pain intensity score was used to quantify patients’ pain relief. Results: During the study period, 25 patients with trigeminal neuralgia (10 males, 15 females; mean [SD] age = 63 [10.4] years) underwent e-MVD. All patients had a preoperative BNI score of V. The left side was affected in 15 patients. Complications occurred in 2 patients: both experienced hearing loss, and one experienced transient facial weakness 7 days after surgery. The facial weakness had resolved by the last follow-up. All patients were completely pain-free (BNI score I) immediately postoperatively. On latest follow-up, 22 patients have remained pain-free, and 3 patients have recurrent pain that is being controlled with medication (BNI score III). Conclusions: Our study demonstrated that e-MVD is a safe, possibly effective method of performing MVD with the added benefit of improved visualization of the operative field for the operating surgeon and the surgical team. Larger prospective studies are required to evaluate whether performing e-MVD confers any additional benefits in long-term clinical outcome of patients with trigeminal neuralgia. |
format |
Article in Journal/Newspaper |
author |
Pak, Ho Lim Lambru, Giorgio Okasha, Mohamed Maratos, Eleni Thomas, Nicholas Shapey, Jonathan Barazi, Sinan |
author_facet |
Pak, Ho Lim Lambru, Giorgio Okasha, Mohamed Maratos, Eleni Thomas, Nicholas Shapey, Jonathan Barazi, Sinan |
author_sort |
Pak, Ho Lim |
title |
Fully Endoscopic Microvascular Decompression for Trigeminal Neuralgia:Technical Note Describing a Single-Center Experience |
title_short |
Fully Endoscopic Microvascular Decompression for Trigeminal Neuralgia:Technical Note Describing a Single-Center Experience |
title_full |
Fully Endoscopic Microvascular Decompression for Trigeminal Neuralgia:Technical Note Describing a Single-Center Experience |
title_fullStr |
Fully Endoscopic Microvascular Decompression for Trigeminal Neuralgia:Technical Note Describing a Single-Center Experience |
title_full_unstemmed |
Fully Endoscopic Microvascular Decompression for Trigeminal Neuralgia:Technical Note Describing a Single-Center Experience |
title_sort |
fully endoscopic microvascular decompression for trigeminal neuralgia:technical note describing a single-center experience |
publishDate |
2022 |
url |
https://kclpure.kcl.ac.uk/portal/en/publications/e5900deb-1c67-4ba9-9b22-b8af2f322158 https://doi.org/10.1016/j.wneu.2022.07.014 http://www.scopus.com/inward/record.url?scp=85136536960&partnerID=8YFLogxK |
genre |
Point Barrow |
genre_facet |
Point Barrow |
op_source |
Pak , H L , Lambru , G , Okasha , M , Maratos , E , Thomas , N , Shapey , J & Barazi , S 2022 , ' Fully Endoscopic Microvascular Decompression for Trigeminal Neuralgia : Technical Note Describing a Single-Center Experience ' , World Neurosurgery , vol. 166 , pp. 159-167 . https://doi.org/10.1016/j.wneu.2022.07.014 |
op_rights |
info:eu-repo/semantics/openAccess |
op_doi |
https://doi.org/10.1016/j.wneu.2022.07.014 |
container_title |
World Neurosurgery |
container_volume |
166 |
container_start_page |
159 |
op_container_end_page |
167 |
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