K. Singh Sahni, M.D., F.A.C.S.
Neurosurgical Associates, P.C., Richmond, VA
10710 Midlothian Turnpike, Suite 138
Richmond, VA 23235
804-330-4990
http://www.trigeminalneuralgiava.com/dr-sahni.htm
Transcript: Glycerol vs. microvascular decompression: How does a patient decide?
Glycerol and microvascular decompression: the choice for the patient. This is actually a decision that is made by the physician and the patient together. It is extremely important the doctor who’s taking care of the patient is actually doing more than one procedure. Now if you’re see a physician who’s just doing microvascular decompression’s and not glycerol or radiofrequency or Gamma Knife, unfortunately there’ll be a lot of discussion only about microvascular decompression. I think this is a decision that has to be made by the patient with his physician’s help.
Therefore, what happens if I’m seeing a patient and we are kind of lost between deciding between the glycerol and the microvascular decompression. First thing is that if that patient is very healthy, biologically in good condition, hasn’t had major medical problems, in those patients, of course, I’m going to be suggesting more of a microvascular decompression because it has a better long term relief and the patient has less recurrence. Having said that, if a patient has medical issues, multiple heart surgeries, bad liver, on aspirin, on blood thinners, you are leaning more towards a less invasive procedure.
Now a patient comes to my office is in extreme pain, can’t eat, can’t talk, usually the family members are there to explain everything what’s going on and at this point, the patient wants to have a quick answer and is actually not in a frame of mind to even think about it himself or herself. Most of the time, a patient coming in in that condition would say “Doc do anything you would do.” At that point, it is important to at least get them some relief. In my practice, I actually will go ahead and do a glycerol right then and there. If I’m seeing them in my office, I’ll take them to the OR and do a quick injection, get them some relief, and then again start talking about the other options. That’s a bit different but I have used glycerol for a quick procedure. Sometimes it involves much less planning than is involved with microvascular decompression. Now, it is not impossible, it’s actually not unheard of that many of these will in the next six months to a year later will end up needing a microvascular decompression and they do get the microvascular decompression done.