微血管减压与伽玛刀放射外科手术对老年特发性三叉神经痛的疗效比较

doi:10.3969/j.issn.1006-6233.2018.04.007

Abstract
Figure/Table
References
Related Citation (0)

Download: PDF (1322 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective: To investigate the effect of microvascular decompression and gamma knife radiosurgery on idiopathic trigeminal neuralgia in the elderly. Methods: 90 patients of idiopathic trigeminal neuralgia in the elderly who received therapy from November 2013 to November 2015 in our hospital were selected. According to different surgical methods,the patients were divided into the microvascular decompression group (n=45) and the gamma knife group (n=45). The curative effect was compared between the two groups after 3 months, and the patients were followed up for 12 months, and the visual analogue scale (VAS) was recorded before and after the operation, and the complication and pain recurrence rate were record. Results: There was no significant difference in the total remission rate between the two groups after 3 months [88.89%(40/45) vs 82.22% (37/45)](P>0.05); the VAS scores in the two groups were significantly lower than those before treatment (P<0.05), there was no significant difference in VAS score between the two groups after operation 1 month (P>0.05), but the VAS scores in the microvascular decompression group were significantly lower than those of the gamma knife group at after operation 3, 6, 9 and 12 months, the difference was statistically significant (P<0.05); there was no significant difference in the incidence of postoperative infection, nausea, vomiting, tinnitus, facial numbness and hearing impairment between the two groups [17.78%(8/45) vs 15.56% (7/45)] (P>0.05); the pain recurrence rate in the microvascular decompression group was significantly lower than those of the gamma knife group at 12 months follow-up [11.11%(5/45) vs 28.89%(13/45)], the difference was statistically significant (P<0.05). Conclusion: Microvascular decompression surgery and gamma knife radiotherapy can relieve senile idiopathic trigeminal neuralgia, but the microvascular decompression remission rate and recurrence rate were better than that of gamma knife radiation in long-term pain, it's more conducive to the treatment of elderly patients with good foundation, But for the basis of poor or can not tolerate surgery, gamma knife radiosurgery also can be used as a good palliative treatment.

Key words： Idiopathic trigeminal neuralgia in the elderly Microvascular decompression Gamma knife radiosurgery

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	LI Jie
	et al

Cite this article:

LI Jie,et al. The Effect of Microvascular Decompression and Gamma Knife Radiosurgery on Idiopathic Trigeminal Neuralgia in the Elderly[J]. HeBei Med, 2018, 24(4): 552-549.

URL:

http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2018.04.007 OR http://www.hbyxzzs.cn/EN/Y2018/V24/I4/552

[1] Baliazin VA, Baliazina EV, Aksenov DP. Computed tomography in the diagnosis of classical trigeminal neuralgia[J].Comput Assist Tomogr, 2017, 41(4): 521~527.
[2] 翟志超,刘金锋. 三叉神经痛治疗进展[J].中国疼痛医学杂志,2015,21(9):641~644.
[3] Cohen J, Mousavi SH, Faraji AH, et al. Stereotactic radiosurgery as initial surgical management for ederly patients with trigeminal neuralgia[J]. Stereotact Funct Neurosurg, 2017, 95(3): 158~165.
[4] 孙晶晶,李建卫,郑晓辉,龙洁.三叉神经痛的临床治疗进展[J].现代生物医学进展,2014,14(26):5189~5193.
[5] 李世亭,郑学胜.三叉神经痛微创外科治疗的现状与思考[J].实用医学杂志,2014,30(21):3375~3378.
[6] Kotecha R, Miller JA, Modugula S, et al. Stereotactic radiosurgery for trigeminal neuralgia improves patient-reported quality of life and reduces depression[J]. Int Radiat Oncol Biol Phys, 2017, 98(5): 1078~1086.
[7] 王忠诚. 王忠诚神经外科学[M].第1版.武汉:湖北科学技术出版社,2005.1025~1031.
[8] Brisman R.Gamma knife surgery with a dose of 75 to 76.8 Gray for trigeminal neuralgia[J].Neurosurg, 2004, 100(5):848~854.
[9] Burkholder DB, Koehler PJ, Boes CJ. Trigeminal neuralgia and multiple sclerosis: a historical perspective[J]. Can Neurol Sci, 2017, 44(5): 589~593.
[10] 姜涛,马林.三叉神经痛病因、病理、发病机制研究进展及影像学的重要作用[J].中国医学影像学杂志,2015,23(4):312~316.
[11] 程岩,刘树堂.三叉神经痛的认识与治疗现状[J].河北医科大学学报,2015,36(1):113~116.
[12] Timarova G, et al. Late-onset jaw and teeth pain mimicking trigeminal neuralgia associated with chronic vagal nerve stimulation: case series and review of the literature[J]. BMC Neurol, 2017, 17(1): 113.
[13] Jannetta PJ.Arterial compression of the trigeminal nerve at the ponsin patients with trigeminal neuralgia[J].Journal of Neurosurgery, 1967,26(1): 159.
[14] Inoue T, Shima A, Hirai H, et al. Nervus intermedius neuralgia treated with microvascular decompression: a case report and review of the literature[J]. NMC Case Rep, 2017, 4(3): 75~78.
[15] Yang YM, Wang ZW, et al. Anatomy and management of superior petrosal vein in microvascular decompression for trigeminal neuralgia[J]. Chinese Medical Journal, 2017, 97(7): 522~524.
[16] 许斌.神经内镜辅助下显微血管减压术治疗面肌痉挛的临床疗效与安全性[J].中国实用神经疾病杂志,2016,19(20):69~71.
[17] Mousavi SH, Akpinar B, Niranjan A, et al. The clinical significance of persistent trigeminal nerve contrast enhancement in patients who undergo repeat radiosurgery[J].Neurosurg, 2017, 127(1):219~225.
[18] Wolf A, Kondziolka D. Gamma knife surgery in trigeminal neuralgia[J]. Neurosurg Clin N Am, 2016, 27(3): 297~304.
[19] Cho YB, Laperriere N, Hodaie M, et al. Hybrid isocenter technique for Gamma-knife perfexion treatment of trigeminal neuralgia[J]. Med Dosim, 2016, 41(4): 271~276.