• Yoshifumi Mizobuchi, Shinji Nagahiro, Akinori Kondo, Kazunori Arita, Isao Date, Yukihiko Fujii, Takamitsu Fujimaki, Ryosuke Hanaya, Mitsuhiro Hasegawa, Toru Hatayama, Tooru Inoue, Hidetoshi Kasuya, Masahito Kobayashi, Eiji Kohmura, Toshio Matsushima, Jun Masuoka, Akio Morita, Shigeru Nishizawa, Yoshihiro Okayama, Taku Shigeno, Hiroshi Shimano, Hideo Takeshima, and Iwao Yamakami.
• Department of Neurosurgery, Faculty of Medicine, Tokushima University, Tokushima, Japan.
• Neurosurgery. 2021 Sep 15; 89 (4): 557-564.

BackgroundMicrovascular decompression (MVD) is the most effective procedure for the long-term management of trigeminal neuralgia (TGN). However, retrospective and single-center studies are inherently biased, and there are currently no prospective, multicenter studies.ObjectiveTo evaluate the short- and long-term outcomes and complications in patients with TGN who underwent MVD at specialized Japanese institutions.MethodsWe enrolled patients with TGN who underwent MVD between April 2012 and March 2015. We recorded their facial pain grade and complications at 7 d (short term), 1 yr (mid-term), and 3 yr (long term) postoperatively.ResultsThere were 166 patients, comprising 60 men and 106 women (mean age 62.7 yr). Furthermore, 105 patients were aged over 60 yr. We conducted neuromonitoring in 84.3% of the cases. The complete pain relief, mortality, and complication rates at the short-term follow-up were 78.9%, 0%, and 16.3%, respectively. Overall, 155 patients (93.4%) completed the long-term follow-up, with the complete pain relief and complication rates of 80.0% and 5.2%, respectively.ConclusionIn the hands of experienced neurosurgeons, MVD for TGN can achieve high long-term curative effects. In addition, complications are uncommon and usually transient. Our results indicate that MVD is an effective and safe treatment for patients with TGN, including elderly patients.© Congress of Neurological Surgeons 2021.

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