Аннотация

Резюме
,
Цель
To evaluate the outcomes of a minimally invasive endoscopic technique for the treatment of classical trigeminal neuralgia aimed at optimizing surgical strategy.
Материал и методы
The study included 52 patients with classical trigeminal neuralgia: 39 women (75%) and 13 men (25%). The mean age was 50.7 ± 14.2 years, with a mean age at disease onset of 55 years. Pain was more frequently localized on the right side (43 cases), while left-sided pain was observed in 9 patients. Pain intensity was assessed using the Visual Analog Scale (VAS). The diagnosis was confirmed according to international diagnostic criteria. All patients underwent endoscopic microvascular decompression of the trigeminal nerve root using a minimally invasive approach.
Результаты
Intraoperative endoscopic findings demonstrated compression of the trigeminal nerve root by the superior cerebellar artery in 38 patients (73.1%), by the petrosal venous complex in 5 patients (9.6%), and a loop of the anterior inferior cerebellar artery (AICA) without classical compression in 9 patients (17.3%). Complete pain relief in the immediate postoperative period was achieved in 43 patients (83%). At admission, pain was assessed as intolerable in 46 patients (88.4%) and very severe in 6 patients (11.5%). Delayed pain regression with analgesic therapy was observed in 7 patients (13.4%), while no clinical improvement was noted in 2 patients (3.8%). No early postoperative complications were recorded. During follow-up, 29 patients (55.7%) remained pain-free.
Заключение
Minimally invasive endoscopic decompression of the trigeminal nerve root demonstrates high clinical efficacy in the treatment of classical trigeminal neuralgia and allows significant improvement in surgical outcomes in this category of patients.

Ключевые слова

magnetic resonance imaging; endoscopy; minimally invasive approach; microvascular decompression; neurovascular conflict; trigeminal neuralgia

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Список литературы

  1. Bendtsen L, Zakrzewska JM, Heinskou TB, Hodaie M, Leal PRL, Nurmikko T, et al. Advances in diagnosis, classification, pathophysiology, and management of trigeminal neuralgia. Lancet Neurol. 2020;19(9):784–796. doi:10.1016/S1474-4422(20)30233-7.
  2. Di Stefano G, Maarbjerg S, Truini A. Trigeminal neuralgia secondary to multiple sclerosis: from the clinical picture to the treatment options. J Headache Pain. 2019;20(1):20. doi:10.1186/s10194-019-0969-0.
  3. Shimansky V.N., Tanyashin S.V., Poshataev V.K. Taktika khirurgicheskogo lecheniya nevralgii troynichnogo nerva v zavisimosti ot komprimirovaniya [Tactics of surgical treatment of trigeminal neuralgia depending on the compressing agent]. Rossiyskiy zhurnal boli. 2018;56(2):244. (In Russ.).
  4. Lee CH, et al. Epidemiology of trigeminal neuralgia: an electronic population health data study in Korea. Korean J Pain. 2021;34(3):332–338. doi:10.3344/kjp.2021.34.3.332.
  5. Kolycheva M.V., Bezborodova T.Yu., Shimanskiy V.N., Strunina Yu.V., Gadzhieva O.A. Karbamazepin v terapii nevralgii troynichnogo nerva [Carbamazepine in the therapy of trigeminal neuralgia]. Rossiyskiy zhurnal boli. 2022;20(4):28–34. (In Russ.).
  6. Wolf A., Kondziolka D. Trigeminal neuralgia and other facial neuralgias. Prog Neurol Surg. 2019;34:273–278. doi:10.1159/000493074.
  7. Alwardian M, Chrysikos D, Samolis A, Papachristou A, Spartalis E, Piagkou M, et al. Trigeminal neuralgia and potential correlations with anatomical variations of the trigeminal nerve. Acta Med Acad. 2021;50(2):292–299. doi:10.5644/ama2006-124.344.
  8. Abdullaev R.A. A Study of the Quality of Life of Patients with Trigeminal Neuralgia Before and After Modern Differentiated Surgical Treatment, American Journal of Medicine and Medical Sciences, Vol. 15 No. 11, 2025, pp. 3868-3872. doi: 10.5923/j.ajmms.20251511.24.
  9. Gerwin R. Chronic facial pain: trigeminal neuralgia, persistent idiopathic facial pain, and myofascial pain syndrome—an evidence-based narrative review and etiological hypothesis. Int J Environ Res Public Health. 2020;17(19):7012. doi:10.3390/ijerph17197012.
  10. Cruccu G, Di Stefano G, Truini A. Trigeminal neuralgia. N Engl J Med. 2020;383(8):754–762. doi:10.1056/NEJMra1914484.
  11. Tai AX, Nayar VV. Update on trigeminal neuralgia. Curr Treat Options Neurol. 2019;21(9):42. doi:10.1007/s11940-019-0583-0.
  12. Olesen J. The International Classification of Headache Disorders: history and future perspectives. Cephalalgia. 2024;44(1):03331024231214731. doi:10.1177/03331024231214731.
  13. Guan H, Li S, Wang X. Fully endoscopic microvascular decompression for trigeminal neuralgia: technical note and early outcomes. Neurosurg Rev. 2023;46(1):292. doi:10.1007/s10143-023-02188-w.
  14. Sun J, Wang J, Jia J, Cao Z, Li Z, Zhang C, et al. Fully endoscopic microvascular decompression for trigeminal neuralgia caused by vertebrobasilar artery: a case series review with 2-dimensional operative video. Oper Neurosurg (Hagerstown). 2023. doi:10.1227/ons.0000000000000998.
  15. Allam AK, Sharma H, Larkin MB, Viswanathan A. Trigeminal neuralgia: diagnosis and treatment. Neurol Clin. 2023;41(1):107–121. doi:10.1016/j.ncl.2022.09.001.
  16. Peng W, Zhao R, Guan F, Liang X, Jing B, Zhu G, et al. Fully endoscopic microvascular decompression for the treatment of hemifacial spasm, trigeminal neuralgia, and glossopharyngeal neuralgia: a retrospective study. BMC Surg. 2023;23(1):331. doi:10.1186/s12893-023-02214-0.