Microvascular decompression for elderly patients with trigeminal neuralgia |
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| Affiliation: | 1. Department of Neurosurgery, Westmead Hospital, Hawkesbury Road, Westmead, NSW 2145, Australia;2. Faculty of Medicine, University of Sydney, Sydney, NSW, Australia;3. Department of Surgery, University of New South Wales, Sydney, NSW, Australia;1. Department of Orthopaedic Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuou-ku, Chiba 260-8670, Japan;2. Department of Orthopaedic Surgery, National Hospital Organization Chiba Medical Center, Chiba, Japan;3. Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan;1. Shandong Cancer Hospital and Institute, 440 Jiyan, Jinan 250117, Shandong Province, China;2. The Second Hospital of Shandong University, Shandong Province, China;3. Affiliated Hospital of Weifang Medical University, Weifang, Shandong Province, China;1. Emergency and Trauma Centre, The Alfred Hospital, Commercial Road, Melbourne, VIC 3004, Australia;2. Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia;3. National Trauma Research Institute, Melbourne, VIC, Australia;4. Emergency Medicine, Hamad Medical Corporation, Doha, Qatar;5. Trauma Service, The Alfred Hospital, Melbourne, VIC, Australia;6. Department of Surgery, Monash University, Melbourne, VIC, Australia;7. Department of Neurosurgery, The Alfred Hospital, Melbourne, VIC, Australia;8. Department of Surgery, F. Edward Hébert School of Medicine, Uniformed Services University of The Health Sciences (USUHS), Bethesda, MD, USA;1. Department of Medicine and Neurology, Melbourne Brain Centre at the Royal Melbourne Hospital, University of Melbourne, Grattan Street, Parkville, VIC 3050, Australia;2. Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China;3. Department of Radiology, Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia;1. Department of Neurosurgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China;2. Center for Diagnosis and Treatment of Cranial Nerve Diseases, Shanghai Jiao Tong University, Shanghai, China;3. Department of Neurosurgery, Affiliated Hospital of Zunyi Medical College, Guizhou, China |
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| Abstract: | ![]()
Microvascular decompression (MVD) has been demonstrated to be an excellent surgical treatment approach in younger patients with trigeminal neuralgia (TN). However, it is not clear whether there are additional morbidity and mortality risks for MVD in the elderly population. We performed a systematic literature review using six electronic databases for studies that compared outcomes for MVD for TN in elderly (cut-off ⩾60, 65, 70 years) versus younger populations. Outcomes examined included success rate, deaths, strokes, thromboembolism, meningitis, cranial nerve deficits and cerebrospinal fluid leaks. There were 1524 patients in the elderly cohort and 3488 patients in the younger cohort. There was no significant difference in success rates in elderly versus younger patients (87.5% versus 84.8%; P = 0.47). However, recurrence rates were lower in the elderly (11.9% versus 15.6%; P = 0.03). The number of deaths in the elderly cohort was higher (0.9% versus 0.1%; P = 0.003). Rates of stroke (2.5% versus 1%) and thromboembolism (1.1% versus 0%) were also higher for elderly TN patients. No differences were found for rates of meningitis, cranial nerve deficits or cerebrospinal fluid leak. MVD remains an effective and reasonable strategy in the elderly population. There is evidence to suggest that rates of complications such as death, stroke, and thromboembolism may be significantly higher in the elderly population. The presented results may be useful in the decision-making process for MVD in elderly patients with TN. |
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| Keywords: | Complications Elderly Microvascular decompression Trigeminal neuralgia |
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