Neurosurgery Blog

Icon

Daily bibliographic review of the Neurosurgery Department. La Fe University Hospital. Valencia, Spain

Prospective Comparison of Posterior Fossa Exploration and Stereotactic Radiosurgery Dorsal Root Entry Zone Target as Primary Surgery for Patients With Idiopathic Trigeminal Neuralgia

Neurosurgery 67:633-639, 2010 DOI: 10.1227/01.NEU.0000377861.14650.98

Trigeminal neuralgia (TN) is the most common facial pain syndrome, with an incidence of approximately 27 per 100 000 patient-years.

OBJECTIVE: To prospectively compare facial pain outcomes for patients having either a posterior fossa exploration (PFE) or stereotactic radiosurgery (SRS) as their first surgery for idiopathic TN.

METHODS: Prospective cohort study of 140 patients with idiopathic TN who had either PFE (n = 91) or SRS (n = 49) from June 2001 until September 2007. The groups were similar with regard to sex, pain location, and pain duration. Patients who had SRS were older (67.1 vs 58.2 years; P < .001). The median follow-up after surgery was 38 months.

RESULTS: Patients who had PFE more commonly were pain free off medications (84% at 1 year, 77% at 4 years) compared with the SRS patients (66% at 1 year, 56% at 4 years; hazard ratio = 2.5; 95% confidence interval, 1.4-4.6; P = .003). Additional surgery for persistent or recurrent face pain was performed in 14 patients after PFE (15%) compared with 17 patients after SRS (35%; P = .009). Nonbothersome facial numbness occurred more frequently in the SRS group (33% vs 18%; P = .04). No difference was noted in other complications between patients who had PFE (12%) (dysesthetic facial pain, n = 3; cerebrospinal fluid leakage, n = 3; hearing loss, n = 2; wound infection, n = 1; pneumonia, n = 1; deep vein thrombosis, n = 1) and patients who had SRS (8%) (dysesthetic facial pain, n = 4; P = .47).

CONCLUSION: PFE is more effective than SRS as a primary surgical option for patients with idiopathic TN

Category: Outcome, Pain

Tagged: , ,

Comments are closed.

The Safety and Feasibility of Image-Guided BrainPath-Mediated Trans-Sulcal Hematoma Evacuation

Haptic Virtual Reality Aneurysm Clipping

Subtemporal Approach for AICA Aneurysm Clipping

MCA Aneurysm Anatomical Classification Scheme

Blister Aneurysms of the Internal Carotid Artery

Bypass for Complex Basilar Aneurysms

Basilar Invagination and Atlanto-Axial Dislocation Video 1

Indocyanine Green Videoangiography “In Negative” Video 2

Indocyanine Green Videoangiography “In Negative” Video 1

Management of a Recurrent Coiled Giant Posterior Cerebral Artery Aneurysm

Bypass for Complex Basilar Aneurysms

Expanded Endonasal Approach for 2012 MERC

Endoscopic Endonasal Middle Clinoidectomy Video 1

Endoscopic Endonasal Middle Clinoidectomy Video 2

Neurosurgery CNS: Flash Fluorescence for MCA Bypass Video 2

Neurosurgery CNS: Flash Fluorescence for MCA Bypass Video 1

Neurosurgery CNS: Endoscopic Transventricular Lamina Terminalis Fenestration Video 2

Neurosurgery CNS: Endoscopic Transventricular Lamina Terminalis Fenestration Video 1

Neurosurgery CNS: Surgery for Giant PCOM Aneurysms Video 2

Neurosurgery CNS: Surgery for Giant PCOM Aneurysms Video 1

NeurosurgeryCNS: Endovascular-Surgical Approach to Cavernous dAVF

Neurosurgery CNS: Lateral Supraorbital Approach Applied to Anterior Clinoidal Meningiomas Video 4

Neurosurgery CNS: Lateral Supraorbital Approach Applied to Anterior Clinoidal Meningiomas Video 3

Neurosurgery CNS: Lateral Supraorbital Approach Applied to Anterior Clinoidal Meningiomas Video 2

Neurosurgery CNS: Lateral Supraorbital Approach Applied to Anterior Clinoidal Meningiomas Video 1

NeurosurgeryCNS: Surgery of AVMs in Motor Areas

NeurosurgeryCNS: The Fenestrated Yaşargil T-Bar Clip

NeurosurgeryCNS: Cotton-Clipping Technique to Repair Intraoperative Aneurysm Neck Tear Video 3

NeurosurgeryCNS: Cotton-Clipping Technique to Repair Intraoperative Aneurysm Neck Tear Video 2

NeurosurgeryCNS: Cotton-Clipping Technique to Repair Intraoperative Aneurysm Neck Tear Video 1

NeurosurgeryCNS. ‘Double-Stick Tape’ Technique for Offending Vessel Transposition in Microvascular Decompression

NeurosurgeryCNS: Advances in the Treatment and Outcome of Brain Stem Cavernous Malformation Surgery: 300 Patients

3T MRI Integrated Neuro Suite

NeurosurgeryCNS: 3D In Vivo Modeling of Vestibular Schwannomas and Surrounding Cranial Nerves Using DIT

NeurosurgeryCNS: Microsurgery for Previously Coiled Aneurysms: Experience on 81 Patients: Video 7

NeurosurgeryCNS: Microsurgery for Previously Coiled Aneurysms: Experience on 81 Patients: Video 6

NeurosurgeryCNS: Microsurgery for Previously Coiled Aneurysms: Experience on 81 Patients: Video 5

NeurosurgeryCNS: Microsurgery for Previously Coiled Aneurysms: Experience on 81 Patients: Video 4

NeurosurgeryCNS: Microsurgery for Previously Coiled Aneurysms: Experience on 81 Patients: Video 3

NeurosurgeryCNS: Microsurgery for Previously Coiled Aneurysms: Experience on 81 Patients: Video 2

NeurosurgeryCNS: Microsurgery for Previously Coiled Aneurysms: Experience on 81 Patients: Video 1

NeurosurgeryCNS: Corticotomy Closure Avoids Subdural Collections After Hemispherotomy

NeurosurgeryCNS: Operative Nuances of Side-to-Side in Situ PICA-PICA Bypass Procedure

NeurosurgeryCNS. Waterjet Dissection in Neurosurgery: An Update After 208 Procedures: Video 3

NeurosurgeryCNS. Waterjet Dissection in Neurosurgery: An Update After 208 Procedures: Video 2

NeurosurgeryCNS. Waterjet Dissection in Neurosurgery: An Update After 208 Procedures: Video 1

NeurosurgeryCNS: Fusiform Aneurysms of the Anterior Communicating Artery

NeurosurgeryCNS. Initial Clinical Experience with a High Definition Exoscope System for Microneurosurgery

NeurosurgeryCNS: Endoscopic Treatment of Arachnoid Cysts Video 2

NeurosurgeryCNS: Endoscopic Treatment of Arachnoid Cysts Video 1

NeurosurgeryCNS: Typical colloid cyst at the foramen of Monro.

NeurosurgeryCNS: Neuronavigation for Neuroendoscopic Surgery

NeurosurgeryCNS:New Aneurysm Clip System for Particularly Complex Aneurysm Surgery

NeurosurgeryCNS: AICA/PICA Anatomical Variants Penetrating the Subarcuate Fossa Dura

Craniopharyngioma Supra-Orbital Removal

NeurosurgeryCNS: Use of Flexible Hollow-Core CO2 Laser in Microsurgical Resection of CNS Lesions

NeurosurgeryCNS: Ulnar Nerve Decompression

NeurosurgeryCNS: Microvascular decompression for hemifacial spasm

NeurosurgeryCNS: ICG Videoangiography

NeurosurgeryCNS: Inappropiate aneurysm clip applications


32,538
Unique
Visitors
Powered By Google Analytics

Total views

  • 0
%d bloggers like this: