Clinical features and long-term surgical outcomes in 39 patients withtumor-related trigeminal neuralgia compared with 360 patients with idiopathic trigeminal neuralgia
| Autor: | Ning Li, Yongxu Wei, Wenlei Yang, Hanbing Shang, Chunhua Pu, Yu Cai, Weiguo Zhao |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Microsurgery medicine.medical_treatment Treatment outcome Kaplan-Meier Estimate Neurosurgical Procedures 03 medical and health sciences Young Adult 0302 clinical medicine Postoperative Complications Trigeminal neuralgia Idiopathic trigeminal neuralgia Medicine Humans Young adult Age of Onset Aged Retrospective Studies Aged 80 and over business.industry Brain Neoplasms Follow up studies Age Factors Retrospective cohort study General Medicine Middle Aged Trigeminal Neuralgia medicine.disease Prognosis Combined Modality Therapy Surgery Treatment Outcome 030220 oncology & carcinogenesis Female Neurology (clinical) Age of onset Nervous System Diseases business 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | British journal of neurosurgery. 31(1) |
| ISSN: | 1360-046X |
| Popis: | The purpose of this study was to compare clinical features, long-term surgical outcomes between patients with idiopathic and tumor-related trigeminal neuralgia (TN), and to identify factors associated with the maintenance of permanent pain-free state.Between January 2003 and December 2013, 360 patients with idiopathic TN and 39 patients with tumor-related TN who had undergone microsurgery were retrospectively studied. Kaplan-Meier survival curves were generated and compared by Log-rank test, and the possible prognostic factors were analyzed by the Cox proportional-hazards regression.Patients with tumor-related TN exhibited a younger age of pain onset (46.28 ± 18.18y vs. 53.03 ± 11.90y, p = .006), a briefer symptom duration (3.20 ± 4.38y vs. 7.01 ± 6.04y, p = .000), and much more preoperative neuropathic deficits (61.54%% vs. 24.17%%, p = .000), as compared with patients with idiopathic TN. Using Kaplan-Meier analysis, we found microsurgery was effective in 72.3% of patients with idiopathic TN, and in 86.4% of cases with tumor-related TN at six years follow-up postoperatively. Prognostic analysis suggested that a clear-cut neurovascular compression in patients with idiopathic TN (HR = 3.098, 95%CI: 1.800-5.311; p = .000) and total tumor removal in patients with tumor secondary TN (HR = 7.662, 95%CI: 0.098-36.574; p = .044) were positively correlated with excellent long-term outcomes.The occurrences of TN at younger age, a shorter duration and preponderance of preclinical neuropathic symptoms are the characteristics of TN patients secondary to intracranial tumor, in contrast to patients with TN caused by a compressed vessel. Microsurgery is an effective and safe treatment modality for TN regardless of the disease etiology, the involvement of a clear-cut vascular offender and total tumor resection are the most important predictors of excellent outcome for microsurgery in idiopathic and tumor-related TN patients, respectively. |
| Databáze: | OpenAIRE |
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