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Safety and efficacy of purely endoscopic microvascular decompression for trigeminal neuralgia: systematic review and single arm meta-analysis

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dc.contributor.author Gago, Guilherme
dc.contributor.author Ruella, Mauro
dc.contributor.author Strangio, Antonio
dc.contributor.author de Lima Gibbon, Frederico
dc.contributor.author Cotrim Gomes, Fernando
dc.contributor.author Lindner, Rafaela J.
dc.contributor.author Gomes Paz, Matheus
dc.contributor.author Champagne, Pierre-Olivier
dc.date.accessioned 2025-03-13T13:34:30Z
dc.date.available 2025-03-13T13:34:30Z
dc.date.issued 2025-02-07
dc.identifier.citation Gago G, Ruella M, Strangio A, de Lima Gibbon F, Gomes FC, Lindner RJ, et al. Safety and efficacy of purely endoscopic microvascular decompression for trigeminal neuralgia: systematic review and single arm meta-analysis. Neurosurg Rev. 7 de febrero de 2025;48(1):216. es_ES
dc.identifier.uri https://doi.org/10.1007/s10143-025-03334-2
dc.identifier.uri https://repositorio.fleni.org.ar/xmlui/handle/123456789/1314
dc.description.abstract Microscopic microvascular decompression(M-MVD) is considered the gold standard treatment for primary trigeminal neuralgia and presents excellent long-term pain control rates. Despite the effectiveness of M-MVD, the use of endoscopy in these procedures has proven to be a promising approach. To evaluate the safety and efficacy of purely endoscopic microvascular decompression (E-MVD). A systematic review of the literature was performed using the PubMed, Scopus, Embase, and Cochrane databases. The primary outcome was satisfactory pain relief in short-term (0-30 days), mid-term (mean follow-up >/= 12 months) and long-term (mean follow-up >/= 24 months). Secondary outcomes were CSF leak, facial weakness, hearing loss, facial numbness, the rate of intraoperative identification of the offending vessel(s), mortality, length of stay and operative time. Inclusion criteria were studies including only patient submitted to E-MVD. Exclusion were secondary trigeminal neuralgia and mean follow-up < 12 months. Statistical analysis was performed using RStudio 2024.04.1 + 748. Heterogeneity was assessed using I² statistics. Sensitivity analysis was performed with leave-one-out test. Thirteen articles met the inclusion criteria, comprising a total of 1336 patients. Patients submitted to E-MVD had mean satisfactory pain relief rates of 92.93% (95% CI: 89.52-96.34% I2 = 86%), 88.54% (95% CI: 83.73-93.54% I2 = 87%) and 83.38% (95% CI: 76.58-90.17% I2 = 83%) in the short-term, mid-term and long-term follow-ups, respectively. Furthermore, the incidence of postoperative complications was low, including CSF leak (1.29% (95% CI: 0.32-2.26% I2 = 20%)), facial weakness (0.50% (95% CI: 0.00-1.79% I2 = 60%)), hearing loss (0.81% (95% CI: 0.05-1.57% I2 = 7%)) and facial numbness (3.84% (95% CI: 1.95-6.20% I2 = 54%)). There was no mortality related to the procedure (0% (95% CI: 0-0%; I2 = 0%)). The offending vessel(s) were identified in 99.57% of the cases (95% CI: 98.17-100.00% I2 = 67%)). Our meta-analysis revealed that E-MVD is a safe and effective procedure for the treatment of primary trigeminal neuralgia. Further studies are necessary to compare its usefulness to the traditional M-MVD approach. es_ES
dc.language.iso eng es_ES
dc.publisher Springer es_ES
dc.subject Endoscopy es_ES
dc.subject Endoscopía es_ES
dc.subject Microvascular Decompression Surgery es_ES
dc.subject Cirugía para Descompresión Microvascular es_ES
dc.subject Neuroendoscopy es_ES
dc.subject Neuroendoscopía es_ES
dc.subject Treatment Outcome es_ES
dc.subject Resultado del Tratamiento es_ES
dc.subject Trigeminal Neuralgia es_ES
dc.subject Neuralgia del Trigémino es_ES
dc.title Safety and efficacy of purely endoscopic microvascular decompression for trigeminal neuralgia: systematic review and single arm meta-analysis es_ES
dc.type info:eu-repo/semantics/article es_ES
dc.description.fil Fil: Ruella, Mauro. Fleni. Departamento de Neurocirugía; Argentina.
dc.relation.ispartofVOLUME 48
dc.relation.ispartofNUMBER 1
dc.relation.ispartofPAGINATION 216
dc.relation.ispartofCOUNTRY Alemania
dc.relation.ispartofCITY Berlín
dc.relation.ispartofTITLE Neurosurgical review
dc.relation.ispartofISSN 1437-2320
dc.type.snrd info:ar-repo/semantics/artículo es_ES


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