Author/Editor		Prestor, Borut; Jugović, Domagoj
Title		Mikrovaskularna dekompresija je učinkovita in varna metoda zdravljenja trigeminusne nevralgije pri starejših bolnikih
Translated title		Microvascular decompression is effective method for treatment of trigeminal neuralgia in elderly patients
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 76, št. 7-8
Publication year		2007
Volume		str. 461-6
Language		slo
Abstract		Background The study aimed to determine the possible differences in the effectiveness of microvascular decompression for the treatment of trigeminal neuralgia between patients aged 65 or younger and patients older than 65 years, and to clarify the efficacy and safety of the MVD in elderly patients. Methods In 40 patients MVD was used for treatment of typical TN. The pain relief immediately and 2 years after MVD for TN in 22 patients aged more than 65 years and in 18 patients younger than 65 years was evaluated and compared between the groups. Other parameters were also compared, such as duration of pain before surgery, operative fitness status, type of vessel (artery or vein) compressing the nerve, length of hospital stay, and complications after the surgery. Results There was no significant difference in immediate pain relief and pain relief 2 years after MVD between the older and younger patients (P = 0.381, P = 0.185), 2 years after MVD, more pain free patients were found in cases of arterial compression in both groups (P < 0.001). The patients in the younger group showed better operative fitness status (P = 0.027). Length of hospital stay was shorter in younger patients (P < 0.001). There were no fatal outcomes, cranial nerve deficits, or any other permanent neurological deficits in either of the groups. Conclusions Microvascular decompression is a safe and effective treatment for typical trigeminal neuralgia in elderly patients. This surgical technique is more successful in cases of trigeminal nerve compression by an artery. Physical fitness and not patient age should be a limiting factor for microvascular decompression as the treatment of choice for trigeminal neuralgia.
Summary		Izhodišča Namen študije je bil ugotoviti, ali obstaja pomembna razlika v uspešnosti zdravljenja trigeminusne nevralgije (TN) z mikrovaskularno dekompresijo (MVD) med skupino bolnikov, starih 65 let ali mlajših, in skupino starejših od 65 let in določiti učinkovitost in varnost to metode pri starejših bolnikih. Metode 40 bolnikov smo operirali zaradi trdovratne tipične TN in pri vseh naredili MVD trigeminusa. Ocenili smo olajšanje bolečine takoj po operaciji in 2 leti po MVD pri 22 bolnikih, starejših od 65 let, in pri 18 bolnikih, mlajših od 65 let. Pri obeh skupinah smo upoštevali še druge dejavnike: trajanje bolečine pred MVD, telesna pripravljenost bolnikov za operacijo, vrsta žile (arterija ali vena), ki je povzročila pritisk na trigeminus, trajanje bolnišničnega zdravljenja in pooperativne zaplete. Rezultati Med obema skupinama ni bilo statistično pomembne razlike pri olajšanju bolečine takoj in 2 leti po MVD (P = 0,382, P = 0,185). Dve leti po MVD je bilo skupaj več bolnikov brez bolečine pri arterijskih kompresijah kot pri venskih (P < 0,001). Mlajši bolniki so bili bolje telesno pripravljeni kot starejši (P = 0,027). Trajanje zdravljenja je bilo krajše pri mlajši skupini bolnikov (P < 0,001). V nobeni skupini ni bilo operativne umrljivosti, okvare možganskih živcev ali drugih resnejših nevroloških zapletov. Zaključki Mikrovaskularna dekompresija je učinkovita in varna metoda zdravljenja trigeminusne nevralgije tudi pri starejših bolnikih. Učinkovitost metode je večja v primerih pritiska arterije na trigeminus. MVD je metoda izbire zdravljenja TN tudi pri starejših telesno dobro pripravljenih bolnikih.
Descriptors		TRIGEMINAL NEURALGIA DECOMPRESSION, SURGICAL MICROSURGERY AGED