Surgical management of trigeminal neuralgia in elderly patients using a small retrosigmoidal approach: analysis of efficacy and safety.

Details

Serval ID
serval:BIB_0146CBB45F51
Type
Article: article from journal or magazin.
Collection
Publications
Title
Surgical management of trigeminal neuralgia in elderly patients using a small retrosigmoidal approach: analysis of efficacy and safety.
Journal
Journal of neurological surgery. Part A, Central European neurosurgery
Author(s)
Martínez-Anda J.J., Barges-Coll J., Ponce-Gomez J.A., Perez-Pena N., Revuelta-Gutierrez R.
ISSN
2193-6323 (Electronic)
ISSN-L
2193-6315
Publication state
Published
Issued date
01/2015
Peer-reviewed
Oui
Volume
76
Number
1
Pages
39-45
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Trigeminal neuralgia is one of the most common causes of facial pain with the highest incidence in individuals > 60 years old. Despite the proven efficacy and safety of microvascular decompression (MVD) for the treatment of trigeminal neuralgia, some physicians are reluctant to perform the procedure in elderly patients because of potential complications.
In the present study, we analyze the outcome of MVDs performed over a 10-year period in elderly patients and compare the results with those obtained in younger patients. A total of 32% of the patients were ≥ 65 years of age at the time of diagnosis. All of the patients were treated via a small retrosigmoidal approach because of reluctance for medical treatment. Overall, 87% of the patients exhibited microvascular compression of the fifth nerve in the root entry zone and were treated using MVD; the remainder of the patients were treated using a trigeminal root compression technique when a vessel was not compressing the fifth nerve.
After the procedure, 93% reported complete relief of pain with a recurrence rate of 10.8% over a mean time of 43 months. A total of 10% of the patients experienced severe complications related to the operation with no mortality.
MVD continues to be the procedure of choice for the treatment of trigeminal neuralgia in patients reluctant to medical treatment, including elderly patients because age is not a contraindication.
Keywords
Aged, Cranial Sinuses/surgery, Female, Humans, Male, Microvascular Decompression Surgery/adverse effects, Microvascular Decompression Surgery/methods, Middle Aged, Recurrence, Retrospective Studies, Treatment Outcome, Trigeminal Neuralgia/surgery
Pubmed
Web of science
Create date
10/09/2019 16:45
Last modification date
11/09/2019 5:26
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