Articles: microvascular-decompression-surgery.
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Microvascular decompression (MVD) is an effective method for directly treating the etiology of trigeminal neuralgia (TGN). This study aims to investigate the factors that predict complete pain relief after MVD for treatment of TGN, and to study efficacy and safety in older patients. ⋯ Presence of typical type TGN was the only factor found to independently predict a pain-free outcome in the early postoperative period. No factors were associated long-term pain-free outcome. MVD is an effective and safe operative procedure, and it should be regarded as a safe and viable alternative for treating intractable TGN in older patients.
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Although microvascular decompression (MVD) has been widely accepted as an effective treatment for hemifacial spasm (HFS), some patients may experience delayed relief instead of immediate improvement after the surgery. The need for and timing of repeat MVD has been controversial to date; thus, we conducted the present study with emphasis on those unrelieved patients. ⋯ Our findings demonstrate that MVD is the most effective treatment for patients with HFS. An early reoperation is easier and safer than a later reoperation and may improve the likelihood of immediate relief.
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Bilateral trigeminal neuralgia is a relatively rare disease. Microvascular decompression (MVD) is a safe and effective treatment for unilateral trigeminal neuralgia; however, its utility in bilateral trigeminal neuralgia is unclear. Here, we report our experience with MVD in 13 cases of primary bilateral trigeminal neuralgia. ⋯ Vascular compression plays a causative role in bilateral and unilateral trigeminal neuralgia. MVD appears to be a safe and effective treatment option in patients who are refractory to pharmacotherapy.
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Journal of neurosurgery · Jan 2018
Meta AnalysisAn investigation into quality of life improvement in patients undergoing microvascular decompression for hemifacial spasm.
OBJECTIVE Hemifacial spasm (HFS) is a movement disorder characterized by involuntary spasms of the facial muscles, and it can negatively impact quality of life (QOL). This retrospective study and systematic review with meta-analysis was conducted to investigate the QOL in patients with HFS following intervention with microvascular decompression (MVD) and botulinum toxin (BT). METHODS In the retrospective analysis, a QOL questionnaire was administered to all patients undergoing MVD performed by a single surgeon. ⋯ Regarding the systematic review, it is reported that approximately 90% of patients undergoing MVD for HFS experience a complete recovery from symptoms, whereas the mean peak improvement of symptoms following treatment with BT is 77%. Furthermore, patients undergoing MVD reported a greater improvement in the mean supplemental index of QOL as compared with patients receiving BT therapy. CONCLUSIONS Microvascular decompression offers a significant improvement in QOL in well-selected patients suffering from HFS, and may offer an increased benefit for QOL over BT injections.
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Comparative Study
Long-term efficacy of initial microvascular decompression versus subsequent microvascular decompression for idiopathic hemifacial spasm.
Hemifacial spasm (HFS) is a disorder characterized by intermittent, involuntary facial muscle contractions. Microvascular decompression (MVD) is the gold treatment for HFS. The aim of this research was to discuss whether patients undergoing MVD as their initial surgical intervention experience greater spasm control than patients experiencing an MVD performed as a subsequent surgical intervention. ⋯ Patients undergoing MVD for HFS as the primary treatment experience better long-term efficacy than patients first treated with botulinum neurotoxin type A.