Clinical research on the microvascular decompression in the treatment of cranial nerve and vascular compression syndromes: report of 1 950 cases

Objective To study the possible means to improve microvascular decompression (MVD) in the treatment of such cranial nerve and vascular compression syndromes as trigeminal neuralgia, hemifacial spasm and glossopharyngeal neuralgia. Methods A systematic review was made for 1 950 cases (1 515 of trigeminal neuralgia, 400 of hemifacial spasm and 35 of glossopharyngeal neuralgia) who underwent from December 1984 to June 2004 microvascular decompression for the treatment of cranial nerve and vascular compression syndromes. Results The offending vessels can be identified in all cases. The number of cases with satisfactory effects is 1 886 with an effective rate of 96.7%, and no case died in this group. The complication rate dropped from 10.55% of 8 years ago to 2.88% of the recent 8 years. Conclusion MVD operation is the most available treatment to the trigeminal neuralgia, hemifacial spasm and glossopharyngeal neuralgia. The key points of the MVD operation include good exposure of REZ, correct identifying of the OV, and proper positioning of Teflon grafts. Various factors need to be considered in order to elevate the cure rate and decrease the possible complications of microvascular decompression. [