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Efficacy and safety of root compression of trigeminal nerve for trigeminal neuralgia without evidence of vascular compression.

AbstractOBJECTIVE:
Trigeminal neuralgia (TN) surgical treatment with microvascular decompression is highly effective and safe, but for a percentage of patients who undergo this procedure, no vascular compression is found. The purpose of this study was to evaluate the long-term efficacy with trigeminal root compression of the trigeminal nerve in patients with TN refractory to medical treatment who underwent neurosurgical management by a retrosigmoid approach of the cerebellopontine angle and were found to be negative for vascular compression.
METHODS:
A prospective collection of clinical data on all patients with a diagnosis of idiopathic TN was conducted at our institution. A total of 277 patients with TN were treated by a keyhole retrosigmoid approach for exploration of the cerebellopontine angle between January of 2000 and August of 2010. A total of 44 patients were found to be negative for vascular compression of the trigeminal nerve; all of these patients underwent trigeminal root compression.
RESULTS:
We found that all patients were pain free after the procedure. There was a 27% relapse in a mean time of 10 months, but 83% of these patients were adequately controlled by medical treatment, and only 17% needed a complementary procedure for pain relief. We also found that 63% of the patients complained of a partial loss of facial sensitivity, but only 1 patient presented with a corneal ulcer. There was a 6.7% rate of significant complications.
CONCLUSIONS:
We concluded that trigeminal root compression is a safe and effective option for patients with primary TN without vascular compression.
AuthorsRogelio Revuelta-Gutierrez, Jaime J Martinez-Anda, Juan Barges Coll, Aurelio Campos-Romo, Nadia Perez-Peña
JournalWorld neurosurgery (World Neurosurg) 2013 Sep-Oct Vol. 80 Issue 3-4 Pg. 385-9 ISSN: 1878-8769 [Electronic] United States
PMID22889619 (Publication Type: Journal Article)
CopyrightCopyright © 2013 Elsevier Inc. All rights reserved.
Topics
  • Blood Vessels (injuries)
  • Facial Nerve Injuries (etiology)
  • Female
  • Follow-Up Studies
  • Humans
  • Kaplan-Meier Estimate
  • Magnetic Resonance Imaging
  • Male
  • Microvascular Decompression Surgery (adverse effects, methods)
  • Middle Aged
  • Postoperative Complications
  • Radiculopathy (surgery)
  • Survival Analysis
  • Treatment Outcome
  • Trigeminal Nerve (surgery)
  • Trigeminal Neuralgia (surgery)

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