Zakrzewska Joanna M, Lopez Benjamin C, Kim Sung Eun, Coakham Hugh B
Oral Medicine, Barts and the London, Queen Mary's School of Medicine and Dentistry, London, England.
Neurosurgery. 2005 Jun;56(6):1304-11; discussion 1311-2. doi: 10.1227/01.neu.0000159883.35957.e0.
There are no reports of patient satisfaction surveys after either a microvascular decompression (MVD) or a partial sensory rhizotomy (PSR) for trigeminal neuralgia. This study compares patient satisfaction after these two types of posterior fossa surgery for trigeminal neuralgia, because it is postulated that recurrences, complications, and previous surgical experience reduce satisfaction.
All patients who had undergone their first posterior fossa surgery at one center were sent a self-complete questionnaire by an independent physician. Among the 44 questions on four standardized questionnaires were 5 questions that related to patient satisfaction and experience of obtaining care. Patients were divided into those having their first surgical procedure (primary) and those who had had previous ablative surgery (nonprimary).
Response rates were 90% (220 of 245) of MVD and 88% (53 of 60) of PSR patients. Groups were comparable with respect to age, sex, duration of symptoms, mean duration of follow-up, and recurrence rates. Overall satisfaction with their current situation was 89% in MVD and 72% in PSR patients. Unsatisfied with the outcome were 4% of MVD and 20% of PSR patients, and this is a significant difference (P < 0.01). Satisfaction with outcome was higher in those undergoing this as a primary procedure. In the primary group, satisfaction was dependent on recurrence and complication/side effects status (each P < 0.01), but this was not the case in the nonprimary group. Patients expressed a desire for earlier posterior fossa surgery in 73% of MVD and 58% of PSR patients, and this was highest in the primary group. The final outcome was considered to be better than expected in 80% of MVD and 54% of PSR patients, but 22% of the PSR group (P < 0.01) thought they were worse off.
Patients undergoing posterior fossa surgery as a primary procedure are most satisfied and PSR patients are least satisfied, partly because of a higher rate of side effects.
目前尚无关于三叉神经痛微血管减压术（MVD）或部分感觉神经根切断术（PSR）后患者满意度调查的报告。本研究比较了这两种后颅窝手术治疗三叉神经痛后的患者满意度，因为推测复发、并发症和既往手术经历会降低满意度。
由一名独立医生向所有在一个中心接受首次后颅窝手术的患者发送一份自我填写的问卷。在四份标准化问卷的44个问题中，有5个问题与患者满意度和获得护理的体验有关。患者被分为首次接受手术的患者（初次手术组）和既往接受过消融手术的患者（非初次手术组）。
MVD患者的回复率为90%（245例中的220例），PSR患者的回复率为88%（60例中的53例）。两组在年龄、性别、症状持续时间、平均随访时间和复发率方面具有可比性。MVD患者对当前状况的总体满意度为89%，PSR患者为72%。对结果不满意的MVD患者占4%，PSR患者占20%，这是一个显著差异（P < 0.01）。作为初次手术接受该治疗的患者对结果的满意度更高。在初次手术组中，满意度取决于复发情况以及并发症/副作用状况（均P < 0.01），但在非初次手术组中并非如此。73%的MVD患者和58%的PSR患者表示希望更早进行后颅窝手术，这在初次手术组中最高。80%的MVD患者和54%的PSR患者认为最终结果比预期更好，但PSR组中有22%的患者（P < 0.01）认为他们的情况更糟。
作为初次手术接受后颅窝手术治疗三叉神经痛的患者满意度最高，而PSR患者满意度最低，部分原因是副作用发生率较高。
