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首页> 外文期刊>Neurosurgical focus >Fully endoscopic microvascular decompression for trigeminal neuralgia: Technique review and early outcomes
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Fully endoscopic microvascular decompression for trigeminal neuralgia: Technique review and early outcomes

机译：三叉神经痛全内镜微血管减压术：技术回顾和早期结果

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Object: Fully endoscopic microvascular decompression (E-MVD) of the trigeminal nerve was initially described more than 1 decade ago, but has not yet gained wide acceptance. The authors present the experience of their first 47 consecutive E-MVDs for trigeminal neuralgia (TN). Methods: All surgeries were performed by a single surgeon (J.Y.K.L.) at the Pennsylvania Hospital at the University of Pennsylvania. Patients prospectively completed pain scales before and after surgery by using the Brief Pain Inventory-Facial outcomes tool. All patients were called on the telephone, and the same outcome tool was administered without reference to their preoperative pain status. Results: Forty-seven patients (17 men) were identified and enrolled. Forty (85%) had Burchiel Type 1 TN. Vascular compression was observed at surgery in 42 patients (89%). No surgery was aborted or converted to microscope. One patient suffered permanent hearing loss, for a permanent neurological morbidity rate of 2%. Overall improvement in pain outcomes was excellent, with a median maximum pain intensity preoperatively of 10 and postoperatively of 0 (p < 0.0001). The mean interference with global function scores were 6.2 preoperatively and reduced to 1.0 at last follow-up (p < 0.0001). The mean interference with facial function was 7.3 preoperatively and reduced to 1.2 at last follow-up (p < 0.0001). The mean follow-up period after surgery was 15 ± 8 months. Conclusions: In experienced hands, E-MVD offers superb visualization and illumination and is both safe and effective, at least in the short term. Further longer-term study is needed to compare E-MVD to traditional microscopic MVD.
机译：目的：三叉神经的全内镜微血管减压术（E-MVD）最初于十多年前被描述，但尚未得到广泛认可。作者介绍了他们的前47次连续E-MVD用于三叉神经痛（TN）的经验。方法：所有手术均由宾夕法尼亚大学宾夕法尼亚医院的一名外科医生（J.Y.K.L.）进行。通过使用简短疼痛库存量-面部结果工具，患者可以预期地完成手术前后的疼痛量表。所有患者都通过电话呼叫，并且使用了相同的结果工具，而没有考虑他们的术前疼痛状态。结果：确认并登记了47例患者（17名男性）。四十（85％）拥有Burchiel 1型TN。手术中观察到血管压缩的患者为42例（89％）。没有手术中止或转为显微镜。一名患者永久性听力丧失，永久性神经系统疾病发病率为2％。疼痛结局的总体改善非常好，术前最大疼痛强度中位数为10，术后最大中位数为0（p <0.0001）。术前对总体功能评分的平均干预为6.2，在最后一次随访时降至1.0（p <0.0001）。术前对面部功能的平均干扰为7.3，在最后一次随访时降低至1.2（p <0.0001）。术后平均随访时间为15±8个月。结论：在经验丰富的手中，E-MVD至少在短期内可提供出色的可视化和照明效果，并且既安全又有效。为了将E-MVD与传统的微观MVD进行比较，还需要进一步的长期研究。

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