Artikel
Microvascular decompression for trigeminal neuralgia – Our experience
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Veröffentlicht: | 30. Mai 2008 |
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Gliederung
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Objective: Microvascular decompression is an accepted, safe and useful surgical technique for the treatment of trigeminal neuralgia, hemifacial spasm, glossopharyngeal neuralgia, and other cranial nerve rhizopathies.
The aim of microdecompressive surgery is to alleviate pulsatile vascular compression on the trigeminal or facial nerves at the root entry zone and along the nerve.
Methods: Between 1990 and 2006, among a series of 207 microdecompressive surgical procedures, 156 patients affected by TN underwent microvascular decompression performed by the senior author (M.S.).
Results: The overall rate of immediate postoperative pain relief was 98%. At two-years follow-up, 141 patients (90%) were totally pain free. There was no surgical mortality in this series, and the morbidity was 2%. The rate of cerebrospinal fistulas was 1%.
Conclusions: In this video the authors conducted a review of MVD operations discussing different anatomical pictures and also a sling technique in which the culprit vessel was transposed and then maintained in position by the arachnoid membrane of the cerebellopontine cistern. A shredded Teflon felt is used then to maintain the position of the vessel avoiding direct contact of the prosthetic material with the nerve. Using this technique we minimize a direct trauma to the nerve and the possibility of scar tissue around it.