A Comparative Review of the Outcome Following MVD and PBC in Patients with Trigeminal Neuralgia.

BACKGROUND

This study aims to systematically review the treatment outcomes of percutaneous balloon compression (PBC) and microvascular decompression (MVD) in patients with trigeminal neuralgia.

METHODS

A systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guideline was performed using PubMed, Embase, and Cochrane Central Registry of Controlled Trials databases. Only those articles with more than 5 years' follow-up length were included in this investigation. To uniformly assess the postoperative outcome, we defined as totally pain free, while the postoperative hospitalization and last follow-up period were defined as and , respectively. The facial numbness was quantified with Barrow Neurological Institute Pain Intensity Score (BNI).

RESULTS

After database searching and screening, 7,797 cases were finally included according to the criteria. The rates were 94.1% (1,551/1,649) and 89.9% (4,962/5,482) following PBC and MVD (odds ratio [OR] = 0.603;  < 0.05), while the rates were 58.1% (921/1,566) and 74.9% (4,549/6,074; OR = 2.089;  < 0.05), respectively. Although a significant higher facial numbness occurred in the PBC group in the early stage, it was mostly diminished 5 years later compared with the MVD group. At long-term follow-up, hypoacusis and facial palsy occurred more often in the MVD group ( < 0.05).

CONCLUSIONS

Both MVD and PBC provide a satisfactory outcome for the patients in the long term. As a simple, safe, and reliable technique, PBC should be considered as a viable alternative.