Abstract | OBJECTIVE:
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.
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Authors | Rogelio Revuelta-Gutierrez, Jaime J Martinez-Anda, Juan Barges Coll, Aurelio Campos-Romo, Nadia Perez-Peña |
Journal | World neurosurgery
(World Neurosurg)
2013 Sep-Oct
Vol. 80
Issue 3-4
Pg. 385-9
ISSN: 1878-8769 [Electronic] United States |
PMID | 22889619
(Publication Type: Journal Article)
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Copyright | Copyright © 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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