Microvascular decompression for idiopathic trigeminal neuralgia and hemifacial spasm

Objective To investigate the efficacy and complications of microvascular decompression technique for idiopathic cranial rhizopathies,including trigeminal neuralgia and hemifacial spasm. Methods 186 patients with idiopathic cranial rhizopathies,including 126 cases of trigeminal neuralgia and 58 cases of hemifacial spasm,were treated with microvascular decompression from March 2001 to August 2008. In cases of trigeminal neuralgia patients,the roots of trigeminal nerve in the cerebellopontine angle were wrapped with duropatch which was then fixed with a silver clip. In cases of hemifacial spasm,the root entry zone of the facial nerve was padded with two or three pieces of duropatch. The mean follow-up time is 5.6 years. Results The efficacy rate in patients with trigeminal neuralgia and hemifacial spasm were 96% and 100%,respectively. The overall incidence of complications was 8.2% withno surgical mortality. Conclusion Microvascular decompression is an effective treatment of idiopathic trigeminal neuralgia and hemifacial spasm. Adaptive surgical technique,three-dimensional anatomy of cerebellopontine angle and surgeons' experience are indispensable combination for excellent outcome.