Efficacy and safety of microvascular decompression and gamma knife surgery treatments for patients with primary trigeminal neuralgia: A prospective study.

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Efficacy and safety of microvascular decompression and gamma knife surgery treatments for patients with primary trigeminal neuralgia: A prospective study.

World Neurosurg. 2018 Apr 26;:

Authors: Zeng YJ, Zhang H, Yu S, Zhang W, Sun XC

Abstract
PURPOSE: To compare the efficacy and safety of microvascular decompression (MVD) and gamma knife surgery (GKS) treatments for trigeminal neuralgia.
METHOD: Patients with primary trigeminal neuralgia were randomly divided into two groups to undergo either MVD or GKS. All patients were followed up for 2 years to evaluate the efficacy, recurrence rates, and complications of their treatment.
RESULTS: Of the 441 enrolled patients, 220 were included in the MVD group and 221 were in the GKS group. There were no deaths in either group. At the 2-year follow-up, 183 patients (83%) in the MVD group reported complete pain relief; 5 (2%) had obvious pain relief; and 20 (9%) had no relief. In the GKS group, 55 patients (25%) reported complete pain relief, 106 (48%) had obvious pain relief, and 37 (17%) had no relief. Also, at the two-year follow-up, there was no significant difference in the recurrence rate (0.45% vs 0.9%) between the two groups. The most common complications in the MVD group were chemical meningitis (6%), cerebrospinal fluid leakage (4%) and facial palsy (4%). Loss of corneal reflex (6 %) and facial numbness (5%) were the most common complications in the GKS group.
CONCLUSION: Both MVD and GKS are effective surgical treatments for trigeminal neuralgia. The rate of complete relief in the MVD group was significantly superior to that in the GKS group. There was no significant difference in the recurrence rates between the groups; however, there were more severe complications in the MVD group than in the GKS group.

PMID: 29705231 [PubMed - as supplied by publisher]

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