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Microvascular Decompression: Salient Surgical Principles and Technical Nuances

Microvascular Decompression: Salient Surgical Principles and Technical Nuances

Published on: July 5, 2011

Microvascular decompression for tinnitus: systematic review.

Brenton Nash¹, Matthew L Carlson^2,3, Jamie J Van Gompel^2,3

¹College of Medicine, University of Vermont, Burlington, Vermont.

Journal of Neurosurgery

|May 21, 2016

Summary

This summary is machine-generated.

Microvascular decompression (MVD) for cranial nerve (CN) VIII offers a 60% success rate for tinnitus relief. A preoperative symptom duration of 5 years or less predicts a good outcome in tinnitus-only cases.

Keywords:

AAO-HNS = American Academy of Otolaryngology–Head and Neck Surgery CBT = cognitive behavioral therapy CN = cranial nerve CPA = cerebellopontine angle FIESTA = fast imaging employing steady-state acquisition HFS = hemifacial spasm MVD = microvascular decompression NVC = neurovascular compression ROC = receiver operating characteristic SNHL = sensorineural hearing loss TN = trigeminal neuralgia functional neurosurgery microvascular decompression retrosigmoid craniotomy tinnitus

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Area of Science:

Neurosurgery
Otolaryngology
Neurology

Background:

Chronic tinnitus significantly impacts quality of life.
Limited effective treatment options exist for severe tinnitus.
Microvascular decompression (MVD) is a surgical option for cranial nerve compression.

Purpose of the Study:

To critically review the literature on MVD outcomes for tinnitus.
To evaluate the efficacy of MVD specifically for tinnitus-only cases.
To identify predictors of successful MVD outcomes in tinnitus patients.

Main Methods:

Systematic literature review of 43 English-language articles from PubMed.
Analysis of cases with tinnitus-only symptomatology.
Distinction between tinnitus-only and mixed symptomatology cases.

Main Results:

A 60% positive outcome rate was observed for MVD in tinnitus-only cases.
A preoperative symptom duration cutoff of 5 years predicted good outcomes (78.6% sensitivity).
Symptom duration exceeding 5 years predicted poor outcomes (80% specificity).

Conclusions:

MVD demonstrates a promising 60% success rate for chronic tinnitus.
Preoperative symptom duration is a key factor in predicting MVD success.
Further research is warranted to optimize MVD for tinnitus treatment.