Standardized analysis for measuring long-term results in patients after trigeminal neuralgia surgery

Objective: To emphasize the importance of patients' actual subjective satisfaction with the outcome of surgery for trigeminal neuralgia (TGN) using a standardized analysis that combines pain relief and complications.Methods: Ninety-four patients with TGN who underwent surgery and were followed up for 2-15 years (2006-2019) at Shiroyama Hospital, Osaka, Japan were enrolled. Patient subjective satisfaction was measured by evaluating the surgical results: the pain score (P) represented residual pain levels, ranging from P-0 (complete pain relief) to P-1, P-2, and P-3, wherein pain persisted in variable degrees. The complication score (C) ranged from C-0 (no complications after surgery) to C-1 and C-2 in which slight or problematic nerve dysfunction remained. The total surgical result for patient satisfaction (T) represented the summed P and C scores (T = P + C). Results: Among the 94 patients, 81 (86.2%) were categorized as having P-0. In 13 (13.8%) patients, the pain persisted with P-1, P-2, or P-3. In 14 (14.9%) patients, complications occurred at the C-1 or C-2 level. The analysis results revealed T-0 in 71 (75.5%), T-1 in 15 (15.9%), T-2 in 5 (5.3%), T-3 in 2 (2.1%), and T-4 in 1 (1. 1%) patient. Conclusions: A standardized analysis is crucial for evaluating the actual surgical results regarding patient satis-faction with microvascular decompression for refractory TGN. Based on our single-institute study with long-term follow-up, our method that combined separate outcomes for pain relief and complication occurrence into a single score effectively measured the actual subjective satisfaction of patients after surgery for TGN.