Cargando…

Outcome Comparison of Drug-Resistant Trigeminal Neuralgia Surgical Treatments—An Umbrella Review of Meta-Analyses and Systematic Reviews

Medical treatment for trigeminal neuralgia (TN) is not always a feasible option due to a lack of full response or adverse effects. Open surgery or percutaneous procedures are advocated in these cases. Several articles have compared the results among different techniques. Nevertheless, the findings o...

Descripción completa

Detalles Bibliográficos
Autores principales: Rapisarda, Alessandro, Battistelli, Marco, Izzo, Alessandro, D’Ercole, Manuela, D’Alessandris, Quintino Giorgio, Polli, Filippo Maria, Santi, Samuele, Martinelli, Renata, Montano, Nicola
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10137121/
https://www.ncbi.nlm.nih.gov/pubmed/37190495
http://dx.doi.org/10.3390/brainsci13040530
_version_ 1785032383321341952
author Rapisarda, Alessandro
Battistelli, Marco
Izzo, Alessandro
D’Ercole, Manuela
D’Alessandris, Quintino Giorgio
Polli, Filippo Maria
Santi, Samuele
Martinelli, Renata
Montano, Nicola
author_facet Rapisarda, Alessandro
Battistelli, Marco
Izzo, Alessandro
D’Ercole, Manuela
D’Alessandris, Quintino Giorgio
Polli, Filippo Maria
Santi, Samuele
Martinelli, Renata
Montano, Nicola
author_sort Rapisarda, Alessandro
collection PubMed
description Medical treatment for trigeminal neuralgia (TN) is not always a feasible option due to a lack of full response or adverse effects. Open surgery or percutaneous procedures are advocated in these cases. Several articles have compared the results among different techniques. Nevertheless, the findings of these studies are heterogeneous. Umbrella reviews are studies sitting at the peak of the evidence pyramid. With this umbrella review, we provided a systematic review of the outcomes of the surgical procedures used for TN treatment. Only systematic reviews and meta-analyses were included following the PRISMA guidelines. Ten articles were enrolled for qualitative and quantitative assessment. Level of evidence was quantified using a specific tool (AMSTAR-2). Results were heterogenous in terms of outcome and measurements. Microvascular decompression (MVD) appeared to be the most effective procedure both in the short-term (pain relief in 85–96.6% of cases) and long-term follow-up (pain relief in 64–79% of cases), although showed the highest rate of complications. The results of percutaneous techniques were similar but radiosurgery showed the highest variation in term of pain relief and a higher rate of delayed responses. The use of the AMSTAR-2 tool to quantify the evidence level scored three studies as critically low and seven studies as low-level, revealing a lack of good quality studies on this topic. Our umbrella review evidenced the need of well-designed comparative studies and the utilization of validated scales in order to provide more homogenous data for pooled-analyses and meta-analyses in the field of TN surgical treatment.
format Online
Article
Text
id pubmed-10137121
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-101371212023-04-28 Outcome Comparison of Drug-Resistant Trigeminal Neuralgia Surgical Treatments—An Umbrella Review of Meta-Analyses and Systematic Reviews Rapisarda, Alessandro Battistelli, Marco Izzo, Alessandro D’Ercole, Manuela D’Alessandris, Quintino Giorgio Polli, Filippo Maria Santi, Samuele Martinelli, Renata Montano, Nicola Brain Sci Review Medical treatment for trigeminal neuralgia (TN) is not always a feasible option due to a lack of full response or adverse effects. Open surgery or percutaneous procedures are advocated in these cases. Several articles have compared the results among different techniques. Nevertheless, the findings of these studies are heterogeneous. Umbrella reviews are studies sitting at the peak of the evidence pyramid. With this umbrella review, we provided a systematic review of the outcomes of the surgical procedures used for TN treatment. Only systematic reviews and meta-analyses were included following the PRISMA guidelines. Ten articles were enrolled for qualitative and quantitative assessment. Level of evidence was quantified using a specific tool (AMSTAR-2). Results were heterogenous in terms of outcome and measurements. Microvascular decompression (MVD) appeared to be the most effective procedure both in the short-term (pain relief in 85–96.6% of cases) and long-term follow-up (pain relief in 64–79% of cases), although showed the highest rate of complications. The results of percutaneous techniques were similar but radiosurgery showed the highest variation in term of pain relief and a higher rate of delayed responses. The use of the AMSTAR-2 tool to quantify the evidence level scored three studies as critically low and seven studies as low-level, revealing a lack of good quality studies on this topic. Our umbrella review evidenced the need of well-designed comparative studies and the utilization of validated scales in order to provide more homogenous data for pooled-analyses and meta-analyses in the field of TN surgical treatment. MDPI 2023-03-23 /pmc/articles/PMC10137121/ /pubmed/37190495 http://dx.doi.org/10.3390/brainsci13040530 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Rapisarda, Alessandro
Battistelli, Marco
Izzo, Alessandro
D’Ercole, Manuela
D’Alessandris, Quintino Giorgio
Polli, Filippo Maria
Santi, Samuele
Martinelli, Renata
Montano, Nicola
Outcome Comparison of Drug-Resistant Trigeminal Neuralgia Surgical Treatments—An Umbrella Review of Meta-Analyses and Systematic Reviews
title Outcome Comparison of Drug-Resistant Trigeminal Neuralgia Surgical Treatments—An Umbrella Review of Meta-Analyses and Systematic Reviews
title_full Outcome Comparison of Drug-Resistant Trigeminal Neuralgia Surgical Treatments—An Umbrella Review of Meta-Analyses and Systematic Reviews
title_fullStr Outcome Comparison of Drug-Resistant Trigeminal Neuralgia Surgical Treatments—An Umbrella Review of Meta-Analyses and Systematic Reviews
title_full_unstemmed Outcome Comparison of Drug-Resistant Trigeminal Neuralgia Surgical Treatments—An Umbrella Review of Meta-Analyses and Systematic Reviews
title_short Outcome Comparison of Drug-Resistant Trigeminal Neuralgia Surgical Treatments—An Umbrella Review of Meta-Analyses and Systematic Reviews
title_sort outcome comparison of drug-resistant trigeminal neuralgia surgical treatments—an umbrella review of meta-analyses and systematic reviews
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10137121/
https://www.ncbi.nlm.nih.gov/pubmed/37190495
http://dx.doi.org/10.3390/brainsci13040530
work_keys_str_mv AT rapisardaalessandro outcomecomparisonofdrugresistanttrigeminalneuralgiasurgicaltreatmentsanumbrellareviewofmetaanalysesandsystematicreviews
AT battistellimarco outcomecomparisonofdrugresistanttrigeminalneuralgiasurgicaltreatmentsanumbrellareviewofmetaanalysesandsystematicreviews
AT izzoalessandro outcomecomparisonofdrugresistanttrigeminalneuralgiasurgicaltreatmentsanumbrellareviewofmetaanalysesandsystematicreviews
AT dercolemanuela outcomecomparisonofdrugresistanttrigeminalneuralgiasurgicaltreatmentsanumbrellareviewofmetaanalysesandsystematicreviews
AT dalessandrisquintinogiorgio outcomecomparisonofdrugresistanttrigeminalneuralgiasurgicaltreatmentsanumbrellareviewofmetaanalysesandsystematicreviews
AT pollifilippomaria outcomecomparisonofdrugresistanttrigeminalneuralgiasurgicaltreatmentsanumbrellareviewofmetaanalysesandsystematicreviews
AT santisamuele outcomecomparisonofdrugresistanttrigeminalneuralgiasurgicaltreatmentsanumbrellareviewofmetaanalysesandsystematicreviews
AT martinellirenata outcomecomparisonofdrugresistanttrigeminalneuralgiasurgicaltreatmentsanumbrellareviewofmetaanalysesandsystematicreviews
AT montanonicola outcomecomparisonofdrugresistanttrigeminalneuralgiasurgicaltreatmentsanumbrellareviewofmetaanalysesandsystematicreviews