Introduction: Trigeminal Neuralgia causes severe paroxysmal facial pain that leads to debilitating quality of life. Pharmacologic management often becomes insufficient, and the microvascular decompression (MVD) procedure is the mainstay surgical intervention. Internal neurolysis (IN) is a novel addition to the MVD procedure to treat trigeminal neuralgia, and its efficacy has not been well tested.
Objective: The objectives of the study are to understand appropriate surgical treatments for trigeminal neuralgia and to determine the efficacy of the additional IN compared to MVD.
Methods: A retrospective cohort study on patients undergoing surgical intervention for trigeminal neuralgia at TJUH was conducted. Surgical treatment types MVD and MVD + IN were evaluated for the following outcomes: pain-free at 3 months follow-up, and changes in number of medications between preoperative visit and post-operative follow-up.
Results: There was no significant change between MVD and MVD + IN for pain-free at 3 months (MVD: 5 out of 5, 100%; MVD + IN: 15 out of 16, 94%; p-value = 0.33) as well as at other time points. In terms of changes in number of medications, MVD and MVD + IN patients similarly showed decreases in medications (MVD: 4 out of 5, 80%; MVD + IN: 12 out of 16, 75%; p-value = 0.83).
Discussion: Internal neurolysis offers patients similar positive outcomes to microvascular decompression and provides an additional treatment option for relapsing patients. Study warrants further investigation on internal neurolysis efficacy with focus on larger sample size and other factors of patient presentation.
Tzou, Daniel, "Post-Operative Outcomes of Surgical Treatment for Trigeminal Neuralgia" (2019). SKMC JeffMD Scholarly Inquiry, Phase 1, Project 1.