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...
Autores principales: | , , , , , , , , |
---|---|
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 |