A SURVEY OF INTRAOPERATIVE AND POSTOPERATIVE COMPLICATIONS ASSOCIATED WITH MICROVASCULAR DECOMPRESSION ALONG WITH INTRAOPERATIVE FINDINGS IN THE MANAGEMENT OF TRIGEMINAL NEURALGIA: A 12-YEAR RETROSPECTIVE ANALYSIS OF 1023 PATIENTS

Abstract

BACKGROUND: In cases of trigeminal neuralgia which are refractory to medical and conservave management, microvascular
decompression (MVD) is regarded as one of the best surgical intervenons in terms of effecveness and long-term symptom relief but
is also associated with serious complicaons.
OBJECTIVE: To determine the frequency of complicaons including both peri and postoperavely associated with microvascular
decompression along with per-operave findings.
METHODOLOGY: This retrospecve analysis was conducted on the medical records of 1023 paents who underwent microvascular
decompression for trigeminal neuralgia from 2010 to 2022 at Prime Teaching Hospital and Ali Instute of Neurosciences, Irfan
General Hospital Peshawar. All those paents diagnosed with refractory trigeminal neuralgia and operated on through microvascular
decompression were included in the study. For categorical variables, frequency and percentages were reported while aer
determining normality through the Shapiro-Wilk test, appropriate reporng measures including mean, median; standard deviaon,
and range were documented.
RESULTS: The majority of the parcipants were females 568 (55.5%) followed by males 455 (44.5%). The complicaons associated
with the procedure were divided into life-threatening condions, leading to mortality in 14 (1.36%) of the paents and morbidity in
63 (6.15%). The complicaons which led to mortality were intracerebral hematoma in 1 paent, extradural hematoma in 1 paent,
and pulmonary edema in 4 paents. Morbidies associated with the procedure were facial palsy or disfigurement in 8 cases out of
which 6 were transient and 2 were permanent, paral hearing loss in 12 and complete in 6 paents.
CONCLUSION: Our study concluded that Mortality was primarily aributed to complicaons such as intracerebral hematoma,
extradural hematoma, and brainstem dysfuncon, underscoring the crical nature of these risks. Significant morbidity was observed,
including facial palsy, hearing loss, and CSF leaks, highlighng the need for comprehensive preoperave evaluaon and postoperave
care.
KEY WORDS: Complicaons, Microvascular Decompression, superior cerebellar artery, trigeminal Neuralgia