title: Treatment of trigeminal neuralgia by posterior fossa microvascular decompression.
abstract: A series of 109 cases of microvascular decompression for intractable trigeminal neuralgia was reviewed. Operations were performed by a single surgeon and cases were reviewed independently by the one author. The failure rate in this study was 17.6%. A further 6.5% of cases endured brief recurrences not requiring treatment. Two-thirds of significant recurrences occurred within the initial 12 months. Long-term complications were experienced in 7.4% of cases. There was one postoperative mortality occurring in a patient with a large fibroblastic meningioma invading the brain stem. The classic Jannetta approach was modified following the first 32 cases allowing the cerebellum to be depressed inferiorly with a subsequent decline in the rate of loss of hearing from 12.5 to 3.7%. In over 70% of cases an aberrant superior cerebellar artery was found compressing the fifth cranial nerve. Patients had dental work performed in an attempt to control the pain prior to operation in 44% of cases.
authors.affiliation: Department of Neurosurgery, Princess Alexandra Hospital, Brisbane, Queensland, Australia.
authors.forename: K
authors.initials: K
authors.lastname: Cutbush
authors.forename: R L
authors.initials: RL
authors.lastname: Atkinson
mesh_terms: D000328:Adult; D000368:Aged; D001259:Ataxia / Q000209:etiology; D005158:Facial Paralysis / Q000209:etiology; D005260:Female; D006311:Hearing Disorders / Q000209:etiology; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D011183:Postoperative Complications; D012008:Recurrence; D016896:Treatment Outcome; D014277:Trigeminal Neuralgia / Q000601:surgery*