Microvascular decompression for trigeminal neuralgia, hemifacial spasm, and glossopharyngeal neuralgia was found to be a largely safe procedure in a study published in Surgical Neurology International. However, patients with diabetes or obesity were at increased risk for reoperation within 30 days.

Researchers evaluated 506 patients who had undergone craniotomy for trigeminal neuralgia, facial nerve disorder, or glossopharyngeal neuralgia from a large US database using International Classification of Diseases-9 codes. 

Adverse events and reoperation within 30 days were recorded and associations between preoperative comorbidities and 30-day outcomes were assessed. 

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Of the 506 patients included in the study, 19 (5.5%) were readmitted within 30 days and 14 (2.8%) underwent re-operation. In univariate analyses, diabetes was found to be associated with increased odds of undergoing reoperation (odds ratio [OR], 6.16; P =.011). 

In multivariate analyses, both diabetes (OR, 6.32; P =.017) and morbid obesity (OR, 5.26; P =.030) were associated with increased odds of undergoing re-operation. Factors that were not associated with increased risk for adverse events were age, operative time, and indication for surgery. No deaths or hemorrhages requiring re-operation were reported.

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The study authors concluded that, “although safe, risk of complications after [microvascular decompression] persist despite optimal surgical management.” They added, “While further research is needed to identify the optimal strategy to reduce readmissions and repeat surgery, additional care in patients with [diabetes or morbid obesity] may help avoid adverse outcomes.”

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Arnone GD, Esfahani DR, Papastefan S, et al. Diabetes and morbid obesity are associated with higher reoperation rates following microvascular decompression surgery: An ACS-NSQIP analysis. Surg Neurol Int. 2017;8:268.