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  • Experience on Microvascular Decompression of Traigeminal nerve using PTFE Pledgets

    Final Number:
    655

    Authors:
    Suresh Jayabalan MCh[Neuro]., FRCS[Neurosurgery]

    Study Design:
    Clinical Trial

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2014 Annual Meeting

    Introduction: Micro Vascular Decompression (MVD) in Trigeminal Neuralgia has been performed as a preferred mode of surgery around the world. The efficacy of the same has been tested in this analysis in an Indian setup using PTFE Pledgets.

    Methods: A retrospective data analysis was carried out for surgeries performed from 10/06/2010 to 11/01/2013 at KMCH, Tamilnadu, India. Mini craniotomy was performed and cranial bone fixation was done using titanium implants. Telephonic and outpatient clinic follow up of patients were carried out. The data was analysed using IBM SPSS Version 20 software.

    Results: 34 patients underwent MVD of whom 19 (55.9%) were males and 15 (44.1%) were females. The Mean (SE) age was 55 (1.58) yrs. The Mean (SE) duration of symptoms (pain) experienced by the patients prior to the surgery was 43 (8.2) months. Pain along the branches of trigeminal nerve V2+V3 (55.9%) had its maximum presentation followed by V3 alone (17.6%), V1+V2 (14.7%), V2 alone (8.8%) and V1 alone (2.9%). CT/MRI finding of the patients showed that Superior Cerebellar Artery was the major culprit in causing compression over the trigeminal nerve in half the patients followed by few vascular loops (11.8%), Anterior Inferior Cerebellar artery (8.8%) and Basilar artery (2.9%). During the surgery offending vessels were analysed as a Cranial and Caudal compression. The same were displaced using PTFE Pledgets. 97.1% of cases are symptom free in a Mean (SE) follow up period of 287.3 (47.5) days. Numbness was noted in 1 patient on his 12th postop day. Recurrence of pain was not noted in any of the follow up patients

    Conclusions: It is evident that MVD is a preferred treatment of choice in patients with trigeminal neuralgia. This procedure can be done safely with equal efficacy using PTFE Pledgets. But it needs longer follow up to comprehend the current findings.

    Patient Care: This procedure using the PTFE Pledgets is safe, cost effective and long lasting in pain releif

    Learning Objectives: Microvascular decompression is the procedure of choice for trigeminal neurlogia. Various material used for the decompression. PTFE Pledgets one such material which is convenient, easily available and cost effective.

    References:

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