Treatment of Trigeminal Neuralgia by Microvascular Decompression through Retrosigmoid Approach (a report of 125 Cases)

Objective To summarize the experience in treating trigeminal neuralgia by microvascular decompression through retrosigmoid approach. Methods Magnetic resonance tomographic angiography (MRTA) were performed before the operation in 125 patients with trigeminal neuralgia who were treated with microvascular decompression through retrotsigmoid approach. The vessels which were responsible for the neuralgia were identified at root exit zone. A piece of shredded Teflon felt was placed between the vessel and the brain stem after the vessel and the nerve were fully dissociated. Results After the operation, the neuralgia disappeared or was significantly relieved in 121 patients and was insignificantly relieved in 4 patients, in whom the neuralgia disappeared after radiofrequency gangliolysis. Following-up of 121 patients, in whom the neuralgia disappeared or was significantly relieved, from 1 to 7 years showed that the trigeminal neuralgia recurred in 2 patients 2 years after the operation and total effective rate was 95.2%. Conclusions MRTA has an important value for determining the vessels which are responsible for the trigeminal neuralgia. Finding out the vessels which are responsible for the neuralgia at root exit zone and full dissociation and decompression of the vessels and the nerves are the key to the successful operation.