title: Endoscopic vascular decompression for the treatment of trigeminal neuralgia: clinical outcomes and technical note.
abstract: OBJECTIVE
  This study sought to describe the operative technique and clinical outcomes in a series of 57 patients with trigeminal neuralgia treated with endoscopic vascular decompression (EVD) alone without the use of microscopy at any point.
  
  
  METHODS
  A prospective observational study was performed on 57 consecutive patients treated with EVD alone for trigeminal neuralgia from October 2005 to October 2010. Patient outcomes were evaluated with respect to pain abatement, complication rate, length of hospital stay, and overall operative time. Pain outcome was graded using the Barrow Neurological Institute pain intensity score (BNI), with BNI 1 considered an excellent result and BNI 2 or 3 considered a good result. Follow-up ranged from 12 to 72 months, with a mean of 32 months. In addition to reporting these cases, our operative technique for EVD is described in detail.
  
  
  RESULTS
  All 57 patients reported severe preoperative pain (BNI 5); 100% of patients achieved immediate postoperative pain control or complete pain relief (BNI 1 to 3), with 82% obtaining an excellent result of BNI 1, and 18% of patients reported good results of BNI 2 or 3. At follow-up, 56 of 57 patients (98%) reported complete relief or well controlled pain (BNI 1 to 3), with 75% obtaining an excellent result of BNI 1; 23% of patients obtained a good result of BNI 2 or 3. The complication rate was 4%, with no mortality. Mean length of hospital stay was 1.6 days, with a range of 1 to 5 days; mean operative time was 133 minutes.
  
  
  CONCLUSIONS
  EVD is a safe and highly effective alternative to the more traditional open microvascular decompression or the more recently developed endoscopically assisted microvascular decompression.
authors.affiliation: Section of Neurosurgery, St. John Providence Hospital and Medical Centers, Michigan State University, Southfield, Michigan, USA. Electronic address: DrPSetty@gmail.com.
authors.forename: Pradeep
authors.initials: P
authors.lastname: Setty
authors.affiliation: Section of Neurosurgery, St. John Providence Hospital and Medical Centers, Michigan State University, Southfield, Michigan, USA.
authors.forename: Andrey A
authors.initials: AA
authors.lastname: Volkov
authors.affiliation: Section of Neurosurgery, St. John Providence Hospital and Medical Centers, Michigan State University, Southfield, Michigan, USA.
authors.forename: Kenneth P
authors.initials: KP
authors.lastname: D'Andrea
authors.affiliation: Department of Neurosurgery, William Beaumont School of Medicine, Oakland University, Rochester, Michigan, USA.
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Pieper
mesh_terms: D000328:Adult; D000368:Aged; D002530:Cerebellopontine Angle / Q000601:surgery*; D002531:Cerebellum / Q000098:blood supply; D002536:Cerebral Arteries / Q000601:surgery; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D008297:Male; D061145:Microvascular Decompression Surgery / Q000379:methods*; D008875:Middle Aged; D044583:Neuroendoscopy / Q000379:methods*; D061646:Operative Time; D011446:Prospective Studies; D019291:Skull Base / Q000601:surgery*; D016896:Treatment Outcome; D014277:Trigeminal Neuralgia / Q000601:surgery*
keywords: Cerebellopontine angle; Endoscopic; Microvascular decompression; Skull base; Trigeminal neuralgia