Analysis Of Efficacy And Complications Of Microvascular Decompression For Single And Multiple Vascular Trigeminal Neuralgia

Objectives:This study evaluated the short-term and long-term efficacy and complications of microvascular decompression after single and multiple vascular compressions,and discussed whether the number of responsible vessels affects the efficacy and complications of microvascular decompression for suspected vascular complications.Whether blood vessels should also be given adequate decompression.Provides reliable clinical experience in the treatment of primary trigeminal neuralgia for microvascular decompression.Methods:Patients with trigeminal neuralgia who underwent microvascular decompression in the Department of Neurosurgery,First Hospital of Shanxi Medical University from January 2010 to December 2013 were selected.Clinical data were collected and followed up for postoperative analysis.Analyze and compare the short-term pain relief,the incidence of complications,and the pain recurrence and complications after 1 to 3years after surgery in patients with a single responsible vessel and multiple responsible vessels.The results of the use of trigeminal neuralgia diagnosis and treatment of Chinese expert consensus scores,the surgical efficacy is divided into very good,good,general,failure four groups,compared single-responsibility vascular group and multiple responsibility of the vascular group after surgery whether there is no difference.Data processing using SPSS 23.0 statistical software,using two independent sample rank sumtest.P <0.05 indicates that the difference was statistically significant.Results:In this study,73 patients with trigeminal neuralgia were included in the study.The number of single-responsible vascular compression patients was 55,and the number of patients with multiple vascular compression was 18.In the single-responsibility vascular group,2 patients were ineffective 1 week after surgery,3 were effective,50 were cured,and the effective rate was 96.36%.In the short-term complications,there were 9 cases of cranial nerve dysfunction,including 6 cases of facial numbness,1 case of hearing impairment,1 case of diplopia,and 1 case of facial paralysis.Fever in 10 cases.Low intracranial pressure syndrome such as nausea,vomiting and other 9 cases.Follow-up results within 3 years after the recurrence of 9 cases,the recurrence rate was 16.36%.The remaining long-term complications were 13 cases of cranial nerve dysfunction,including 11 cases of facial numbness,1 case of hearing impairment,and 1 case of facial paralysis.In the multiple-responsibility vascular group,1 patient was ineffective 1 week after surgery,1 patient was effective,16 patients were cured,and the effective rate was94.44%.In the short-term complications,2 cases of cranial nerve dysfunction were facial numbness.Fever in 4 cases.Low intracranial pressure syndrome in 3 cases.Follow-up results within 3 years after the recurrence of 2 cases,the recurrence rate was 11.11%.The remaining complications were facial numbness in 3 cases.SPSS23.0 statistical software was used to perform two independent sample rank sum tests,P>0.05,indicating that the single-responsibility vascular group in the short-term or long-term efficacy after microvascular decompression was not different from the multiple-responsibility vascular group.Conclusions:1.Microvascular decompression for the treatment of trigeminal neuralgia is safe and highly effective.Regardless of the short-term efficacy or long-term efficacy assessment,there is no difference between the single-responsibility vascular compression patient and the multiple-responsibility vascular compression patients.The number of responsible blood vessels that compress the trigeminal nerve is not a factor that influences the difference in postoperative efficacy of microvascular decompression.2.Multiple decompression in the operation will not cause the difference in efficacy and complications after microvascular decompression.It is recommended that all suspicious and responsible blood vessels be isolated as far as possible and fully decompressed.Trigeminal nerve wrap isolation can also be an effective decompression method.