title: Endoscopic microvascular decompression: a stepwise operative technique.
abstract: OBJECTIVE
  Microvascular decompression (MVD) of the trigeminal nerve is a widely accepted treatment for patients with trigeminal neuralgia caused by vascular compression. The neuroendoscope is rapidly becoming a complementary tool in minimally invasive neurosurgery of the ventral anterior skull base. Its adoption in the lateral approach to the posterior fossa has been slower and has been used primarily as an adjunct to conventional microscopic surgical techniques, e.g. endoscope-assisted microsurgery.
  
  
  METHODS
  In this paper, we describe a stepwise, technical commentary on a purely endoscopic MVD of the trigeminal nerve via the retrosigmoid route.
  
  
  RESULTS
  From our experience, the endoscope provides excellent visualization of the neurovascular relationship. By allowing full visualization of the trigeminal nerve, endoscopy may likely lead to an increase in the number of successful MVDs and a decrease in the number of complications.
  
  
  CONCLUSIONS
  We believe endoscopic MVD is a safe and effective method of accessing the trigeminal nerve in the cerebellopontine angle and of performing MVD. This endoscopic technique can be implemented in other neurosurgical and neuro-otological procedures such as resection of cerebellopontine angle masses.
authors.affiliation: Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pa. 19104, USA. shihshan.lang@uphs.upenn.edu
authors.forename: Shih-Shan
authors.initials: SS
authors.lastname: Lang
authors.forename: H Isaac
authors.initials: HI
authors.lastname: Chen
authors.forename: John Y K
authors.initials: JY
authors.lastname: Lee
mesh_terms: D005260:Female; D006801:Humans; D061145:Microvascular Decompression Surgery / Q000379:methods*; D008875:Middle Aged; D044582:Neuroendoscopes; D044583:Neuroendoscopy / Q000379:methods*; D014276:Trigeminal Nerve / Q000601:surgery*; D014277:Trigeminal Neuralgia / Q000601:surgery*