gms | German Medical Science

70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12.05. - 15.05.2019, Würzburg

Preoperative duration of symptoms is the most influential risk factor for treatment failure following microvascular decompression for trigeminal neuralgia

Die Präoperative Dauer von Symptomen ist der wesentliche Risikofaktor für Therapieversagen nach mikrovaskulärer Dekompression bei Trigeminusneuralgie

Meeting Abstract

  • presenting/speaker Ehab Shiban - Klinikum rechts der Isar, Technische Universität München, Neurochirurgische Klinik, München, Deutschland
  • A. P. Fritsche - Klinikum rechts der Isar, Technische Universität München, Neurochirurgische Klinik, München, Deutschland
  • Bawarjan Schatlo - Universitätsmedizin Göttingen, Neurochirurgische Klinik, Göttingen, Deutschland
  • Silvia Hernández-Durán - Universitätsmedizin Göttingen, Neurochirurgische Klinik, Göttingen, Deutschland
  • Veit Rohde - Universitätsmedizin Göttingen, Neurochirurgische Klinik, Göttingen, Deutschland
  • Christian F. Freyschlag - Medizinische Universität Innsbruck, Neurochirurgische Klinik, Innsbruck, Austria
  • Claudius Thomé - Medizinische Universität Innsbruck, Neurochirurgische Klinik, Innsbruck, Austria
  • P. da Cunha - Centro Hospitalar Universitário de Coimbra, Serviço de Neurocirurgia, Coimbra, Portugal
  • M. Barbosa - Centro Hospitalar Universitário de Coimbra, Serviço de Neurocirurgia, Coimbra, Portugal
  • Malte Ottenhausen - Vivantes Klinikum Neukölln, Neurochirurgische Klinik, Berlin, Deutschland
  • A. Jödicke - Vivantes Klinikum Neukölln, Neurochirurgische Klinik, Berlin, Deutschland
  • M. Gandia-Gonzalez - Hospital Universitario La Paz, Neurosurgery Department, Madrid, Spain
  • A. K. Demetriades - University of Edinburgh, Neurosurgery Department, Edinburgh, United Kingdom
  • A. Natalwala - University of Edinburgh, Neurosurgery Department, Edinburgh, United Kingdom
  • Lennart Barthel - Universitätsklinik Essen, Neurochirurgische Klinik, Essen, Deutschland
  • Ulrich Sure - Universitätsklinik Essen, Neurochirurgische Klinik, Essen, Deutschland
  • V. Vanaclocha - Hospital General Universitario de Valencia, Neurosurgery Department, Valencia, Spain
  • G. Blasco - Hospital Universitario de La Princesa, Neurosurgery Department, Madrid, Spain
  • L. Mastronardi - Ospedale San Filippo Neri, Neurosurgery Department, Roma, Italy
  • Florian Ringel - Universitätsmedizin Mainz, Neurochirurgische Klinik, Mainz, Deutschland
  • Naureen Keric - Universitätsmedizin Mainz, Neurochirurgische Klinik, Mainz, Deutschland
  • P. González-López - Hospital General Universitario de Alicante, Neurosurgery Department, Alicante, Spain
  • R. Lau Rodriguez - Bellvitge Hospital, Neurosurgery Department, Barcelona, Spain
  • Peter Vajkoczy - Charite – Universitätsmedizin Berlin, Neurochirurgische Klinik, Berlin, Deutschland
  • D. Seggewiß - Charite – Universitätsmedizin Berlin, Neurochirurgische Klinik, Berlin, Deutschland
  • F. Ruiz Juretschke - Hospital General Universitario Gregorio Maranon, Neurosurgery Department, Madrid, Spain
  • R. Garcia Leal - Hospital General Universitario Gregorio Maranon, Neurosurgery Department, Madrid, Spain
  • L. Ley - Hospital Universitario Ramon y Cajal, Neurosurgery Department, Madrid, Spain
  • S. Rocha Romero - Hospital Virgen del Rocío, Neurosurgery Department, Sevilla, Spain
  • Walter Stummer - Universitätsklinikum Münster, Neurochirurgische Klinik, Münster, Deutschland
  • Christian Ewelt - Universitätsklinikum Münster, Neurochirurgische Klinik, Münster, Deutschland
  • M. Bolch - University Masaryk Hospital, Neurosurgery Department, Ústí nad Labem, Czech Republic
  • M. Sameš - University Masaryk Hospital, Neurosurgery Department, Ústí nad Labem, Czech Republic
  • Bernhard Meyer - Klinikum rechts der Isar, Technische Universität München, Neurochirurgische Klinik, München, Deutschland
  • J. Lehmberg - Klinikum rechts der Isar, Technische Universität München, Neurochirurgische Klinik, München, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie. Würzburg, 12.-15.05.2019. Düsseldorf: German Medical Science GMS Publishing House; 2019. DocV065

doi: 10.3205/19dgnc080, urn:nbn:de:0183-19dgnc0805

Veröffentlicht: 8. Mai 2019

© 2019 Shiban et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Objective: The gold standard for the treatment of classic trigeminal neuralgia (TN) is carbamazepine. However, the efficacy of carbamazepine is compromised by its adverse effects. Aim of this study is to assess the clinical outcome following the surgical treatment of TN and to find potential factors for treatment failure.

Methods: A multicenter retrospective data analysis was performed. Primary outcome was the rate of pain free patients at last follow up. At final follow up, a telephone interview for patients satisfaction was conducted.

Results: 970 patients from 20 European institutions were analyzed. Follow up data was obtained form 881 (90.8%). 414 patients were male (43%) mean age was 61 years. Mean duration of symptoms until surgery was 70.6 months (5.8 years). Of the 858 patients with available imaging data, 615 (71.6%) had a visible conflict on the MRI. 62.2% of patients were pain free at last follow up. Facial hypoesthesia was the most common complication and was seen in 18.4% of patients. There were no mortalities. Regression analysis revealed than only preoperative duration of symptoms correlated with treatment failure (p=0.012). Telephone interviews were conducted with 699 (72%) patients. Of those 599 (85%) were satisfied with surgery and 459 (65%) would have preferred earlier surgery.

Conclusion: Microvascular decompression for trigeminal neuralgia is a safe and effective treatment method and should probably be done early on. A randomized controlled study comparing MVD to best medical management is warranted.