AUTHOR=Ji Ye , Wang Junwu 

TITLE=Comparison of microvascular decompression and percutaneous balloon compression efficacy in patients with V2 idiopathic trigeminal neuralgia

JOURNAL=Frontiers in Neurology

VOLUME=15

YEAR=2024

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2024.1406602

DOI=10.3389/fneur.2024.1406602

ISSN=1664-2295

ABSTRACT=<sec id="sec1"><title>Objective</title><p>This study aims to compare the efficacy and long-term prognosis of microvascular decompression (MVD) versus percutaneous balloon compression (PBC) in patients with idiopathic V2 (maxillary branch) trigeminal neuralgia.</p></sec><sec id="sec2"><title>Methods</title><p>We retrospectively analyzed the clinical information and follow-up data of patients who underwent surgical treatment for V2 idiopathic trigeminal neuralgia from January 2020 to January 2023. A total of 58 patients were included in the MVD group and 99 in the PBC group. All surgeries were performed by two physicians at the same center, with follow-up conducted by a separate, trained researcher. We compared the initial versus 12-month postoperative pain relief rates (scored using the BNI), surgical complications, and described pain relief rates after long-term follow-up in both groups using Kaplan–Meier analysis.</p></sec><sec id="sec3"><title>Results</title><p>The study included a total of 157 patients (MVD 58, PBC 99). The median age of patients in the MVD group was lower than that in the PBC group (58 [51–65] vs. 63 [58–69], <italic>p</italic> = 0.002). There was no significant difference between the two groups in terms of pain relief rates initially after surgery and at 12 months (<italic>p</italic> = 0.521, <italic>p</italic> = 0.713). However, the MVD group had significantly better outcomes regarding postoperative facial numbness (<italic>p</italic> &lt; 0.0001), masticatory weakness (<italic>p</italic> = 0.0017), and other complications (<italic>p</italic> = 0.04). Kaplan–Meier analysis showed that MVD provided a longer duration of pain relief than PBC (<italic>p</italic> = 0.0323), with most recurrences in both groups occurring within 1–2 years after surgery.</p></sec><sec id="sec4"><title>Conclusion</title><p>There were no significant differences in significant pain relief rates between the two groups initially after surgery and at 12 months. However, the MVD group showed a clear advantage over PBC regarding postoperative facial numbness, masticatory weakness, and other complications; moreover, Kaplan–Meier analysis revealed that MVD offers a longer duration of pain relief for patients.</p></sec>