Standardized analysis for measuring long-term results in patients after trigeminal neuralgia surgery

Abstract

Objective: To emphasize the importance of patients’ actual subjective satisfaction with the outcome of surgery for trigeminal neuralgia (TGN) using a standardized analysis that combines pain relief and complications. Methods: Ninety-four patients with TGN who underwent surgery and were followed up for 2–15 years (2006–2019) at Shiroyama Hospital, Osaka, Japan were enrolled. Patient subjective satisfaction was measured by evaluating the surgical results: the pain score (P) represented residual pain levels, ranging from P-0 (complete pain relief) to P-1, P-2, and P-3, wherein pain persisted in variable degrees. The complication score (C) ranged from C-0 (no complications after surgery) to C-1 and C-2 in which slight or problematic nerve dysfunction remained. The total surgical result for patient satisfaction (T) represented the summed P and C scores (T = P + C). Results: Among the 94 patients, 81 (86.2%) were categorized as having P-0. In 13 (13.8%) patients, the pain persisted with P-1, P-2, or P-3. In 14 (14.9%) patients, complications occurred at the C-1 or C-2 level. The analysis results revealed T-0 in 71 (75.5%), T-1 in 15 (15.9%), T-2 in 5 (5.3%), T-3 in 2 (2.1%), and T-4 in 1 (1. 1%) patient. Conclusions: A standardized analysis is crucial for evaluating the actual surgical results regarding patient satisfaction with microvascular decompression for refractory TGN. Based on our single-institute study with long-term follow-up, our method that combined separate outcomes for pain relief and complication occurrence into a single score effectively measured the actual subjective satisfaction of patients after surgery for TGN.

Keywords

• Follow-up
• Microvascular decompression
• Patient satisfaction
• Standardized analysis
• Surgical outcome
• Trigeminal neuralgia