{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T02:29:43Z","timestamp":1780540183602,"version":"3.54.1"},"reference-count":35,"publisher":"Georg Thieme Verlag KG","issue":"02","license":[{"start":{"date-parts":[[2024,2,7]],"date-time":"2024-02-07T00:00:00Z","timestamp":1707264000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurol Surg B Skull Base"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003Microvascular decompression (MVD) is the preferred treatment for refractory trigeminal neuralgia (TN) and hemifacial spasm (HFS). MVD provides long-lasting results for these conditions with a relatively low risk of postoperative complications. However, reoperation rates are reported up to 11%, an unacceptably high rate for an elective procedure. We determined what factors may increase the risk of reoperation among patients undergoing MVD for TN or HFS.<\/jats:p><jats:p>\n          Methods\u2003Patient data from 2015 to 2020 were obtained from the American College of Surgeons\u2013National Surgical Quality Improvement Program database and were included in this study if they had a procedure corresponding to an MVD with the current procedural terminology code 61458. Patient demographics, comorbidities, and outcomes were analyzed. Patients were subsequently categorized based on body mass index (BMI) and a logistic regression analysis was used to model the association of comorbidities with reoperation and its indication.<\/jats:p><jats:p>\n          Results\u2003The overall rate of reoperation in the cohort is 3.2 and 7.2% for patients with morbid obesity (BMI \u2265 40; p\u2009=\u20090.006). Patients with morbid obesity were more likely to present at a younger age (50.1 vs. 57.4; p\u2009&lt;\u20090.0001), have comorbidities such as hypertension (60.9 vs. 33.5%; p\u2009&lt;\u20090.0001) and diabetes (16.3 vs. 7.7%; p\u2009=\u20090.0002), and increased procedure duration (179 vs. 164\u2009minutes; p\u2009=\u20090.02). Indications for reoperation include cerebrospinal fluid (CSF) leak (31%), wound complications (19%), refractory pain (11.9), intracranial hemorrhage (4.8%), and other\/unknown (33.3%). Patients with either morbid obesity or diabetes have a 2-fold increase in risk of reoperation, while having both is associated with a 5-fold risk of reoperation.<\/jats:p><jats:p>\n          Conclusion\u2003We demonstrate morbid obesity leads to increased procedure duration and increased risk of reoperation due to wound complications and CSF leak. In these patients, alternative treatment strategies or preoperative optimization may be reasonable to reduce the risk of surgical complications and reoperation.<\/jats:p>","DOI":"10.1055\/a-2263-1778","type":"journal-article","created":{"date-parts":[[2024,2,7]],"date-time":"2024-02-07T23:53:56Z","timestamp":1707350036000},"page":"234-242","source":"Crossref","is-referenced-by-count":3,"title":["Morbid Obesity and Diabetes Increase the Risk of Reoperation following Microvascular Decompression: A National Surgical Quality Improvement Program Analysis of 1,303 Patients"],"prefix":"10.1055","volume":"86","author":[{"given":"Alper","family":"Dincer","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tufts Medical Center, Boston, Massachusetts, United States"},{"name":"Department of Neurosurgery, Yale School of Medicine, New Haven, Connecticut, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna K.","family":"Tabor","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Yale School of Medicine, New Haven, Connecticut, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandros F.","family":"Pappajohn","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Yale School of Medicine, New Haven, Connecticut, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"O'Brien","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Yale School of Medicine, New Haven, Connecticut, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saul","family":"Morales-Valero","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Yale School of Medicine, New Haven, Connecticut, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miri","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Yale School of Medicine, New Haven, Connecticut, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Moliterno","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Yale School of Medicine, New Haven, Connecticut, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2024,3,18]]},"reference":[{"issue":"02","key":"ref1","doi-asserted-by":"crossref","first-page":"1582","DOI":"10.3892\/etm.2020.8871","article-title":"Clinical efficacy of MVD combined with PSR in the treatment of primary trigeminal neuralgia","volume":"20","author":"G Zhao","year":"2020","journal-title":"Exp Ther 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