Acta Neurochirurgica

, Volume 154, Issue 5, pp 773–778 | Cite as

A proposal for standardized analysis of the results of microvascular decompression for trigeminal neuralgia and hemifacial spasm

  • Akinori Kondo
  • Isao Date
  • Shunro Endo
  • Kiyotaka Fujii
  • Yukihiko Fujii
  • Takamitsu Fujimaki
  • Mitsuhiro Hasegawa
  • Touru Hatayama
  • Kazuhiro Hongo
  • Touru Inoue
  • Masatsune Ishikawa
  • Masanori Ito
  • Takamasa Kayama
  • Eiji Kohmura
  • Toshio Matsushima
  • Shigeru Munemoto
  • Shinji Nagahiro
  • Kikuro Ohno
  • Tomomi Okamura
  • Hiroshi Ryu
  • Taku Shigeno
  • Reizo Shirane
  • Yutaka Tagusagawa
  • Hideki Tanabe
  • Kazuo Yamada
  • Iwao Yamakami
Clinical Article

Abstract

Background

The purpose of this study was to evaluate and analyze overall postoperative results from microvascular decompression (MVD) by combining the cure rate of symptoms with the complication rate. A new scoring system for obtaining objective surgical results from MVD for trigeminal neuralgia (TN) and hemifacial spasm (HFS) is proposed to document treatment results using consistent criteria in a standardized manner.

Method

Surgical results combining complications , if any, were obtained from a questionnaire sent to patients who had undergone surgery for TN or HFS in recent years and had been followed-up for more than 1 year after surgery (TN patients, n = 54; HFS patients, n = 81) When surgical outcome is complete resolution of symptoms, the efficacy of surgery (E) is designated E-0, but when moderate symptoms are still persist postoperatively, the score is designated E-2. When no complications are seen after surgery, the complication score (C) is C-0, while the score is C-2 if troublesome complications remain. In addition, total evaluation of the results (T) is judged by combining the E and C scores. For example, when E is 0, and C is C-2, the total evaluation is scored as T-2, which is diagnosed as fair.

Findings

The response rate of the questionnaire was 80.7% (109/135). Overall surgical data were evaluated and analyzed using our new scoring system. Analysis of the collected data revealed an outcome of T-0 was 70% (35/50 patients) and T-1 was 24% (12/50) and T-2 was 6% (3/50) in TN, whereas in HFS, T-0 was 61% (36/59) and T-1 was 27.1% (16/59) and T-2 was 6.8% (4/59) and T-3 was 5.1% (3/59).

Conclusion

The total results of MVD should be evaluated and analyzed by combining the cure rate of symptoms together with the complication rate. This new scoring system could allow much more objective analysis of the results of following MVD. Adopting this scoring system to objectively judge treatment results for TN and HFS, individual surgeons can compare their own overall surgical results with those of other institutes. Comparative results of MVD can also be provided to patients considering therapy to allow informed decision-making on the basis of good quality evidence.

Keywords

Microvascular decompression Trigeminal neuralgia Hemifacial spasm Surgical results New scoring system 

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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Akinori Kondo
    • 1
  • Isao Date
    • 2
  • Shunro Endo
    • 3
  • Kiyotaka Fujii
    • 4
  • Yukihiko Fujii
    • 5
  • Takamitsu Fujimaki
    • 6
  • Mitsuhiro Hasegawa
    • 7
  • Touru Hatayama
    • 8
  • Kazuhiro Hongo
    • 9
  • Touru Inoue
    • 10
  • Masatsune Ishikawa
    • 11
  • Masanori Ito
    • 12
  • Takamasa Kayama
    • 13
  • Eiji Kohmura
    • 14
  • Toshio Matsushima
    • 15
  • Shigeru Munemoto
    • 16
  • Shinji Nagahiro
    • 17
  • Kikuro Ohno
    • 18
  • Tomomi Okamura
    • 19
  • Hiroshi Ryu
    • 20
  • Taku Shigeno
    • 21
  • Reizo Shirane
    • 22
  • Yutaka Tagusagawa
    • 23
  • Hideki Tanabe
    • 24
  • Kazuo Yamada
    • 25
  • Iwao Yamakami
    • 26
  1. 1.Department of Neurosurgery, Brain, Spine and Neurology CenterShiroyama HospitalHabikino CityJapan
  2. 2.Department of NeurosurgeryOkayama University HospitalOkayama CityJapan
  3. 3.Department of NeurosurgeryToyama University HospitalToyama CityJapan
  4. 4.Department of NeurosurgeryKitasato University HospitalSagamihara CityJapan
  5. 5.Department of NeurosurgeryNiigata University Brain Research InstituteNiigata CityJapan
  6. 6.Department of NeurosurgerySaitama Medical University HospitalIruma-gun SaitamaJapan
  7. 7.Department of NeurosurgeryFujita Health University HospitalToyoake CityJapan
  8. 8.Department of NeurosurgeryAomori Municipal HospitalAomori CityJapan
  9. 9.Department of NeurosurgeryShinshuu University HospitalMatsumoto CityJapan
  10. 10.Department of NeurosurgeryFukuoka University HospitalFukuoka CityJapan
  11. 11.Department of NeurosurgeryRakuwakai Otowa HospitalKyoto CityJapan
  12. 12.Department of NeurosurgeryJuntendo University Urayasu HospitalUrayasu CityJapan
  13. 13.Department of NeurosurgeryYamagata University HospitalYamagata CityJapan
  14. 14.Department of NeurosurgeryKobe University HospitalKobe CityJapan
  15. 15.Department of NeurosurgerySaga University HospitalSaga CityJapan
  16. 16.Department of NeurosurgeryIshikawa Prefectural Central HospitalKanazawa CityJapan
  17. 17.Department of Neurosurgery, BrainTokushima University HospitalTokushima CityJapan
  18. 18.Department of NeurosurgeryTokyo Medical Dental University HospitalTokyoJapan
  19. 19.Department of Neurosurgery BrainUbe Industries Central HospitalUbe CityJapan
  20. 20.Department of NeurosurgeryAoyama General HospitalToyokawa CityJapan
  21. 21.Department of NeurosurgeryKanto Rosai HospitalKawasaki CityJapan
  22. 22.Department of NeurosurgeryMiyagi Chidren’s HospitalSendai CityJapan
  23. 23.Department of NeurosurgeryMitsui Memorial HospitalTokyoJapan
  24. 24.Department of NeurosurgeryTanabe Neurosurgical HospitalFujiidera CityJapan
  25. 25.Department of NeurosurgeryNagoya City Universiry HospitalNagoya CityJapan
  26. 26.Department of NeurosurgeryChiba Central Medical CenterChiba CityJapan

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