Featured Research

from universities, journals, and other organizations

More common procedures for painful facial tics carry high costs

Date:
August 22, 2014
Source:
Wolters Kluwer Health: Lippincott Williams and Wilkins
Summary:
For patients who need surgery for facial pain caused by trigeminal neuralgia, the most cost-effective procedure is the least often used, reports a study. Trigeminal neuralgia is a relatively common chronic pain condition, especially among older adults. Sometimes called "tic douloureux," trigeminal neuralgia is associated with a typical pattern of painful facial tics. Pain is thought to be caused by blood vessels placing pressure on the trigeminal nerve in the face.

For patients who need surgery for facial pain caused by trigeminal neuralgia, the most cost-effective procedure is the least often used, reports a study in the September issue of Neurosurgery, official journal of the Congress of Neurological Surgeons. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

Related Articles


Percutaneous stereotaxic rhizotomy (PSR) provides good pain relief at much lower cost than other types of surgical treatments for trigeminal neuralgia, according to the report by Dr. Siviero Agazzi and colleagues of University of South Florida, Tampa. The researchers write, "PSR, despite being the most cost-effective, is by far the least utilized treatment modality."

Surgical Options for Trigeminal Neuralgia

Trigeminal neuralgia is a relatively common chronic pain condition, especially among older adults. Sometimes called "tic douloureux," trigeminal neuralgia is associated with a typical pattern of painful facial tics. Pain is thought to be caused by blood vessels placing pressure on the trigeminal nerve in the face.

When pain from trigeminal neuralgia can't be adequately controlled by medications, various surgical procedures may be recommended. To compare the cost-effectiveness of different surgical options, the researchers analyzed data on Medicare claims for trigeminal neuralgia during 2011. Of 1,582 patients with trigeminal neuralgia, 94 patients -- six percent of the total -- underwent surgical treatment.

Fifty-one percent of surgically treated patients underwent a procedure called microvascular decompression (MVD), in which a pad is placed to relieve pressure on the nerve. Forty-two percent underwent stereotactic radiosurgery (SRS), a less-invasive "gamma knife" procedure. The remaining seven percent of patients underwent PSR -- a percutaneous operation in which the nerve fibers causing pain are destroyed by a needle inserted from the cheek all the way into the skull.

But although PSR was the least commonly used procedures, it was the least expensive, with an average weighted cost of about $3,900. That was about one-tenth the cost of the other two options: about $40,000 for MVD and $38,000 for SRS.

Wide Variations in Cost-Effectiveness

Based on published data, all three procedures reduced pain from trigeminal neuralgia, with some differences in effectiveness. Over ten years, average "quality-adjusted life-years" (QALYs) -- reflecting one year free of pain and without pain medications -- were 8.2 for MVD, 4.9 for SRS, and 6.5 for PSR.

After accounting for these differences, PSR was by far the most cost-effective option. Cost per QALY gained was about $600 with PSR, compared to $4,900 for MVD and $7,800 for SRS. Percutaneous stereotaxic rhizotomy was eight times more cost-effective than MVD and 13 times more cost-effective than SRS.

Dr. Agazzi and coauthors emphasize that their Medicare claims study is only preliminary. It was based on small numbers of patients -- including just seven treated with PSR. It also included limited data on outcomes and complications, such as facial numbness.

But within those limitations, the results suggest that PSR is an "under-utilized" procedure for patients with painful facial tics. The PSR procedure provides comparable pain relief, at a fraction of the cost of more commonly performed procedures. While further research is needed, Dr. Agazzi and colleagues note their findings are consistent with the only two previous studies evaluating the cost-effectiveness of surgical options for trigeminal neuralgia.


Story Source:

The above story is based on materials provided by Wolters Kluwer Health: Lippincott Williams and Wilkins. Note: Materials may be edited for content and length.


Journal Reference:

  1. Sananthan Sivakanthan, Jamie J. Van Gompel, Puya Alikhani, Harry van Loveren, Ren Chen, Siviero Agazzi. Surgical Management of Trigeminal Neuralgia. Neurosurgery, 2014; 75 (3): 220 DOI: 10.1227/NEU.0000000000000430

Cite This Page:

Wolters Kluwer Health: Lippincott Williams and Wilkins. "More common procedures for painful facial tics carry high costs." ScienceDaily. ScienceDaily, 22 August 2014. <www.sciencedaily.com/releases/2014/08/140822124502.htm>.
Wolters Kluwer Health: Lippincott Williams and Wilkins. (2014, August 22). More common procedures for painful facial tics carry high costs. ScienceDaily. Retrieved January 30, 2015 from www.sciencedaily.com/releases/2014/08/140822124502.htm
Wolters Kluwer Health: Lippincott Williams and Wilkins. "More common procedures for painful facial tics carry high costs." ScienceDaily. www.sciencedaily.com/releases/2014/08/140822124502.htm (accessed January 30, 2015).

Share This


More From ScienceDaily



More Health & Medicine News

Friday, January 30, 2015

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Oxfam Calls for Massive Aid for Ebola-Hit West Africa

Oxfam Calls for Massive Aid for Ebola-Hit West Africa

AFP (Jan. 29, 2015) Oxfam International has called for a multi-million dollar post-Ebola "Marshall Plan", with financial support given by wealthy countries, to help Guinea, Sierra Leone and Liberia to recover. Duration: 01:10 Video provided by AFP
Powered by NewsLook.com
Are We Winning The Fight Against Ebola?

Are We Winning The Fight Against Ebola?

Newsy (Jan. 29, 2015) The World Health Organization announced the fight against Ebola has entered its second phase as the number of cases per week has steadily dropped. Video provided by Newsy
Powered by NewsLook.com
Calif. Health Officials Campaign Against E-Cigarettes

Calif. Health Officials Campaign Against E-Cigarettes

Newsy (Jan. 29, 2015) The California Health Department says e-cigarettes are a public health risk for both smokers and those who inhale e-cig smoke secondhand. Video provided by Newsy
Powered by NewsLook.com
Measles Scare Sends 66 Calif. Students Home

Measles Scare Sends 66 Calif. Students Home

AP (Jan. 29, 2015) Officials say 66 students at a Southern California high school have been told to stay home through the end of next week because they may have been exposed to measles and are not vaccinated. (Jan. 29) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins