Title: The exploration of microvascular decompression for trigeminal neuralgia
Abstract: Objective To explore the surgical treatment method of trigeminal neuralgia (TN). Methods We performed microvascular decompression (MVD) operation on 96 patients with TN in the period of June 2000 to May 2006. The operation was performed under general anesthesia, patients were placed in the park bench position, the length of retroauricular incision was 4 cm, the diameter of bone window was 2 cm, and dura was opened as K shape. The operation procedure was closely examined with microscope and endoscope, compressing arteries were mobilized away from the nerve, and the compressing veins were coagulated and divided. A small piece of Teflon was interpositioned between the nerve and the artery to prevent recontact. After hemostasis, the dura was closed and bony defect was repaired before musculofascial closure in layers. The mean follow-up duration was 31 months (3 months-6 years) in 73 cases. The outcomes were evaluated by Giovanni Broggi's criteria. Results Arteries compressing the trigeminal nerve were superior cerebellar artery (81 cases), superior cerebellar artery and anterior inferior cerebellar artery (6 cases), anterior inferior cerebellar artery (5 cases), superior cerebellar artery and petrosal vein (1 case), superior cerebellar artery and posterior cerebral artery (1 case), basilar artery (1 case), and vascular without name (1 case). The outcome after operation was excellent in 94 cases (97.92%), and the result was good in 2 cases. After operation, vertigo with various degree occurred in 31 cases, herpes simplex occurred in 29 cases, incision infection occurred in 2 cases, and postoperative facial numbness occurred in 7 cases. There were no operative mortality or morbidity, and no recurrent cases. Conclusion MVD is a safe, microinvasive and the most effective surgical modality for TN. We propose that any patients with TN who are fit for general anesthesia should choose MVD first.
Publication Year: 2007
Publication Date: 2007-01-01
Language: en
Type: article
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