Author (Year) Groups Studied and Intervention Results and Findings Conclusions
He et al. (2019)[@123980] A total of 912 patients who received microvascular decompression (MVD) for their primary cranial nerve neuralgias were retrospectively analyzed to determine if they had post-operative delirium in order to determine the risk factors. Nearly 24% (221) of the 912 patients experienced post-operative dementia. The risk factors were determined to be:
“old age, male sex, hypertension, preoperative carbamazepine use, postoperative sleep disturbance, and tension pneumocephalus”
These risk factors can be used to preemptively stop a potentially deadly delirium in those affected before undergoing microvascular decompression for a cranial nerve neuralgia.
Bartek et al. (2016)[@123981] A group of 98 adult patients with cranial nerve pain who were treated with MVD were retrospectively analyzed to determine complications after 30 days using a standardized form. Overall complication rate:
20%
Grade I: 14%
Grade II: 5%
Grade III: 1%
(Using Landriel Ibanez classification for neurosurgical complications)
They concluded there was a 20% complication rate with the majority of said complications being able to be treated without using any invasive methods and not life threatening. However, they were unable to compare with other literature to know if 20% is a successful rate or not because as of yet, there is no standardization in the literature, which this study hopes to accomplish.
Ma et al. (2016)[@123982] 103 patients with GN were treated with either glossopharyngeal rhizotomy (GPNR) alone or had it in combination with a partial vagus nerve rhizotomy (GPNR+VNR) and retrospectively analyzed Only 79 of 103 could be contacted
38 GPNR alone:
Immediate pain relief: 94.7%
Immediate complication rate: 7.9%
Long-term pain relief: 92.3%
Long-term complications: 3.8%
65 GPNR+VNR:
Immediate pain relief: 93.8%
Immediate complication rate:4.6%
Long-term pain relief: 94.3%
Long-term complications: 35.8%
While both are a safe and effective way of reducing associated pain with long-term pain relief for around 93% of subjects, the combination with vagus nerve rhizotomy had around a 9 times higher complication rate long-term.
Xia et al. (2017)[@123979] 228 patients with GN were treated with MVD and then retrospectively analyzed to determine long-term outcomes Immediate post-op outcome:
89.5% - excellent
5.3% - good
2.6% - fair
2.6% - poor
>5-year follow-up (107 cases):
86.9% - excellent
5.6% - good
2.8% fair
4.7% - poor
MVD is an effective and safe treatment option for long-term relief of GN.
Rui et al. (2019)[@123983] Patients with GN were retrospectively analyzed after treatment with MVD or MVD plus rhizotomy of the glossopharyngeal nerve (MVD + GNR). Twenty-two patients were treated with MVD alone and 15 patients were treated with MVD + GNR. MVD alone:
19 cases cured
3 cases improved
  • Complications:
    • 2 hoarseness (short-term) and drinking induced cough, 1 CSF leakage, 1 intracranial infection, 1 ipsilateral hearing loss
MVD + GNR:
14 cured
1 improved
  • Complications
    • 2 permanent hoarseness, 4 drinking induced cough (short-term) and hoarseness, 1 ipsilateral facial paralysis, 1 CSF leakage

No significant difference was noted.
No significant difference in the cure rates. Higher rate of complications such as a cough associated with drinking and hoarseness with MVD + GNR. Their study indicates that treatment with the addition of rhizotomy to MVD does not raise the incidence of cure rates of patients with GN and actually may increase the risk of complications.
Funct et al. (2020)[@123984] A total of 46 patients with GN unable to be treated medically were treated with MVD. A retrospective analysis was performed to determine whether MVD alone without rhizotomy was enough to control their pain. 100% of patients had immediate post-operative pain relief after MVD alone.
After 1 year, only one patient had occasional return of pain.
MVD by itself without rhizotomy is a safe and effective treatment option for those with a painful GN that is unable to be managed medically.