The microsurgical management of patients with recurrent trigeminal neuralgia after microvascular decompression

Objective To study the microsurgical management of patients with recurrent trigeminal neuralgia after microvascular decompression. Methods 37 cases of patients with recurrent trigeminal neuralgia alter microvascular decompression were treated by microsurgical operations from 1998 to 2005. 30 cases were treated by partial rhizotomy(PR) of the sensory root of trigeminal nerve, 3 eases were treated by microvascular decompression (MVD) , MVD and PR were performed simultaneously in 4 cases. Results Severe adhesion of local arachnoid membrane was found in 95% cases. All cases were followed up for about 38.2 months (mean duration). The total effective rate during the follow-up period was 97%. The complications included: Facial numbness was found in all cases of PR; 1 case had hearing dysfunction and facial paralysis; I diplopia, 1 bacterial meningitis and 1 cerebellar hematoma. Conclusion Severe adhesion of local arachnoid membrane was the main cause of recurrence of postoperative trigeminal neuralgia. The partial rhizotorny of sensory root of trigeminal nerve should be the choice of the second microsurgical procedure.