A proposal for standardized analysis of the results of microvascular decompression for trigeminal neuralgia and hemifacial spasm
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- 作者：Akinori Kondo (1)
Isao Date (2)
Shunro Endo (3)
Kiyotaka Fujii (4)
Yukihiko Fujii (5)
Takamitsu Fujimaki (6)
Mitsuhiro Hasegawa (7)
Touru Hatayama (8)
Kazuhiro Hongo (9)
Touru Inoue (10)
Masatsune Ishikawa (11)
Masanori Ito (12)
Takamasa Kayama (13)
Eiji Kohmura (14)
Toshio Matsushima (15)
Shigeru Munemoto (16)
Shinji Nagahiro (17)
Kikuro Ohno (18)
Tomomi Okamura (19)
Hiroshi Ryu (20)
Taku Shigeno (21)
Reizo Shirane (22)
Yutaka Tagusagawa (23)
Hideki Tanabe (24)
Kazuo Yamada (25)
Iwao Yamakami (26) - 关键词：Microvascular decompression ; Trigeminal neuralgia ; Hemifacial spasm ; Surgical results ; New scoring system
- 刊名：Acta Neurochirurgica
- 出版年：2012
- 出版时间：May 2012
- 年：2012
- 卷：154
- 期：5
- 页码：773-778
- 全文大小：170KB
- 参考文献：1. Barker FG II, Jannetta PJ, Bissonette DJ, Shields PT, Larkins MV, Jho HD (1955) Microvascular decompression for hemifacial spasm. J Neurosurg 82:201-10
2. Barker FG II, Jannetta PJ, Bissonette DJ, Larkins MV, Jho HD (1966) The long-term outcome of microvascular decompression for trigeminal neuralgia. N Engl J Med 334:1077-083 CrossRef
3. Chen HI, Lee JY (2010) The measurement of pain in patients with trigeminal neuralgia. Clin Neurosurg 57:129-31
4. Henson CF, Goldman HW, Rosenwasser RH, Downes MB, Bednarz G, Pequignot EC, Werner-Wasik M, Curran WJ, Andrews DW (2005) Glycerol rhizotomy versus gamma knife radiosurgery for the treatment of trigeminal neuralgia; an analysis of patients treated at one institution. Int J Radiat Oncol Biol Phys 63(1):82-0 CrossRef
5. Jannetta PJ (1977) Observations on the etiology of trigeminal neuralgia, hemifacial spasm, acoustic nerve dysfunction and glossopharyngeal neuralgia: definitive microsurgical treatment and results in 117 patients. Neurochirurgie 20:145-54
6. Kalkanis SN, Eskander EN, Carter BS, Barker FG II (2003) Microvascular decompression surgery in the United States, 1996 to 2000: Mortality rates, morbidity rates, and the effects of hospital and surgeon volumes. Neurosurgery 52(6):1251-262 CrossRef
7. Kondo A (1997) Follow-up results of microvascular decompression in trigeminal neuralgia and hemifacial spasm. Neurosurgery 40(1):46-2
8. Little AS, Shetter AG, Shetter ME, Bay C, Rogers CL (2008) Long–term pain response and quality of life in patients with typical trigeminal neuralgia treated with Gamma knife stereotactic radiosurgery. Neurosurgery 63(5):915-24 CrossRef
9. McLaughlin MR, Jannetta PJ, Clyde BL, Subach BR, Comey CH, Resnik DK (1999) Microvascular decompression of cranial nerves: lessons learned after 4400 operations. J Neurosurg 90:1- CrossRef
10. Rogers CL, Shetter AG, Fiedler JA, Smith KA, Han PP, Speiser BL (2000) Gamma knife radiosurgery for trigeminal neuralgia; the initial experience of the Barrow Neurological Institute. Int J Radiat Oncol Biol Phys 47(4):1013-019 CrossRef
11. Taha JM, Tew JM Jr (1996) Comparison of surgical treatment for trigeminal neuralgia: reevaluation of radiofrequency rhizotomy. Neurosurgery 38(5):865-71 CrossRef
12. Yamamoto Y, Kondo A, Hanakita J, Nishihara T (1987) Measurement and clinical significance of the posterior fossa volume of patients with hemifacial spasm. No Shinkei Geka 15:243-48 - 作者单位：Akinori Kondo (1)
Isao Date (2)
Shunro Endo (3)
Kiyotaka Fujii (4)
Yukihiko Fujii (5)
Takamitsu Fujimaki (6)
Mitsuhiro Hasegawa (7)
Touru Hatayama (8)
Kazuhiro Hongo (9)
Touru Inoue (10)
Masatsune Ishikawa (11)
Masanori Ito (12)
Takamasa Kayama (13)
Eiji Kohmura (14)
Toshio Matsushima (15)
Shigeru Munemoto (16)
Shinji Nagahiro (17)
Kikuro Ohno (18)
Tomomi Okamura (19)
Hiroshi Ryu (20)
Taku Shigeno (21)
Reizo Shirane (22)
Yutaka Tagusagawa (23)
Hideki Tanabe (24)
Kazuo Yamada (25)
Iwao Yamakami (26)
1. Department of Neurosurgery, Brain, Spine and Neurology Center, Shiroyama Hospital, 2-8-1 Habikino, Habikino City, Osaka, 583-0872, Japan
2. Department of Neurosurgery, Okayama University Hospital, 2-5-1 Shikada-cho kita-ku, Okayama City, 700-8558, Japan
3. Department of Neurosurgery, Toyama University Hospital, 2630 Sugitani, Toyama City, 930-0152, Japan
4. Department of Neurosurgery, Kitasato University Hospital, 1-15-1 Kitasato Minami-ku, Sagamihara City, 228-8555, Japan
5. Department of Neurosurgery, Niigata University Brain Research Institute, 1-757 Asahimachi Chuou-ku, Niigata City, 951-8585, Japan
6. Department of Neurosurgery, Saitama Medical University Hospital, 38 Moro Hongo Moroyama-cho, Iruma-gun Saitama, 350-0493, Japan
7. Department of Neurosurgery, Fujita Health University Hospital, 1- Dengakutubo Kutugake, Toyoake City, 470-1192, Japan
8. Department of Neurosurgery, Aomori Municipal Hospital, 1-14-20 Katuta, Aomori City, 030-0821, Japan
9. Department of Neurosurgery, Shinshuu University Hospital, 3-1-1 Asahi, Matsumoto City, 390-8621, Japan
10. Department of Neurosurgery, Fukuoka University Hospital, 7-45-1 Nanakuma Jounan-ku, Fukuoka City, 814-0810, Japan
11. Department of Neurosurgery, Rakuwakai Otowa Hospital, 2 Otowatinji-cho Yamashina-ku, Kyoto City, 607-8062, Japan
12. Department of Neurosurgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu City, Chiba, 279-0021, Japan
13. Department of Neurosurgery, Yamagata University Hospital, 2-2-2 IIda Nishi, Yamagata City, 990-9585, Japan
14. Department of Neurosurgery, Kobe University Hospital, 7-5-2 Kusunoki-cho Chuou-ku, Kobe City, 650-0071, Japan
15. Department of Neurosurgery, Saga University Hospital, 5-1-1 Nabeshima, Saga City, 849-8501, Japan
16. Department of Neurosurgery, Ishikawa Prefectural Central Hospital, 2-1 Kuratuki Higashi, Kanazawa City, 920-8201, Japan
17. Department of Neurosurgery, Brain, Tokushima University Hospital, 3-18-5 Kuramoto-cho, Tokushima City, 770-0042, Japan
18. Department of Neurosurgery, Tokyo Medical Dental University Hospital, 1-5-45 Yushima Bunkyo-ku, Tokyo, 113-8549, Japan
19. Department of Neurosurgery Brain, Ube Industries Central Hospital, 750 Nishikiha, Ube City, 755-0151, Japan
20. Department of Neurosurgery, Aoyama General Hospital, 1-100 Kosakai, Toyokawa City, Aichi, 441-0195, Japan
21. Department of Neurosurgery, Kanto Rosai Hospital, 2035 Kitukisumiyosi Nakahara-ku, Kawasaki City, 211-0021, Japan
22. Department of Neurosurgery, Miyagi Chidren’s Hospital, 171-4-3-17 Ochiai Aoba-ku, Sendai City, 989-3126, Japan
23. Department of Neurosurgery, Mitsui Memorial Hospital, 1 Izumi Kanda Chiyoda-ku, Tokyo, 101-0024, Japan
24. Department of Neurosurgery, Tanabe Neurosurgical Hospital, 2-91 Nonaka, Fujiidera City, 583-0014, Japan
25. Department of Neurosurgery, Nagoya City Universiry Hospital, 1 Kawasumi Mizuho Mizuhio-ku, Nagoya City, 467-8601, Japan
26. Department of Neurosurgery, Chiba Central Medical Center, 1835-1 Kasori Wakaba-ku, Chiba City, 264-0023, Japan
文摘
Background The purpose of this study was to evaluate and analyze overall postoperative results from microvascular decompression (MVD) by combining the cure rate of symptoms with the complication rate. A new scoring system for obtaining objective surgical results from MVD for trigeminal neuralgia (TN) and hemifacial spasm (HFS) is proposed to document treatment results using consistent criteria in a standardized manner. Method Surgical results combining complications , if any, were obtained from a questionnaire sent to patients who had undergone surgery for TN or HFS in recent years and had been followed-up for more than 1?year after surgery (TN patients, n--4; HFS patients, n--1) When surgical outcome is complete resolution of symptoms, the efficacy of surgery (E) is designated E-0, but when moderate symptoms are still persist postoperatively, the score is designated E-2. When no complications are seen after surgery, the complication score (C) is C-0, while the score is C-2 if troublesome complications remain. In addition, total evaluation of the results (T) is judged by combining the E and C scores. For example, when E is 0, and C is C-2, the total evaluation is scored as T-2, which is diagnosed as fair. Findings The response rate of the questionnaire was 80.7% (109/135). Overall surgical data were evaluated and analyzed using our new scoring system. Analysis of the collected data revealed an outcome of T-0 was 70% (35/50 patients) and T-1 was 24% (12/50) and T-2 was 6% (3/50) in TN, whereas in HFS, T-0 was 61% (36/59) and T-1 was 27.1% (16/59) and T-2 was 6.8% (4/59) and T-3 was 5.1% (3/59). Conclusion The total results of MVD should be evaluated and analyzed by combining the cure rate of symptoms together with the complication rate. This new scoring system could allow much more objective analysis of the results of following MVD. Adopting this scoring system to objectively judge treatment results for TN and HFS, individual surgeons can compare their own overall surgical results with those of other institutes. Comparative results of MVD can also be provided to patients considering therapy to allow informed decision-making on the basis of good quality evidence.