Microvascular decompression for trigeminal neuralgia using the 'Stitched Sling Retraction' technique in recurrent cases after previous microvascular decompression.
BACKGROUND
Microvascular decompression is a well-known therapeutic option for trigeminal neuralgia. It is considered safe and effective, and is the surgical treatment of choice for the malady. However, there is no standard technique for it and different authors have proposed different techniques of performing it. In this study, we observe the clinical results of the so-called 'stitched sling retraction' technique for recurrent cases of trigeminal neuralgia.


METHODS
Twelve consecutive patients with recurrent trigeminal neuralgia after previous microvascular decompression(s) were admitted to our institution form February 2009 to February 2011 and underwent microvascular decompression of the trigeminal nerve using the 'stitched sling retraction' technique. In this technique, the offending loop of the superior cerebellar artery is retracted from the nerve and, using a silk thread loop around it, is suspended to the adjacent tentorium.


RESULTS
All patients experienced pain resolution during the immediate post-operative period or within the first 6 months after surgery. They were followed for 24 to 38 months. No recurrence occurred.


CONCLUSIONS
The 'stitched sling retraction' technique shows promising preliminary results in recurrent cases of trigeminal neuralgia after previous microvascular decompression(s). Since it is a 'transposing' technique, it might be associated with less recurrence rates (due to resuming of the neurovascular conflict) than the classic interposing technique, which uses a prosthesis between the offending vessel and the trigeminal nerve.
Department of Neurosurgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran, tayebi_a77@yahoo.com.
Ali Tayebi
AT
Meybodi
Zohreh
Z
Habibi
Mojtaba
M
Miri
Seyed Ali Fakhr
SA
Tabatabaie
D000328:Adult; D000368:Aged; D001488:Basilar Artery / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D061145:Microvascular Decompression Surgery / Q000379:methods*; D008875:Middle Aged; D011475:Prosthesis Failure; D012008:Recurrence; D012086:Reoperation / Q000379:methods; D013536:Suture Techniques; D016896:Treatment Outcome; D014276:Trigeminal Nerve / Q000601:surgery; D014277:Trigeminal Neuralgia / Q000601:surgery*