title: Second microvascular decompression for trigeminal neuralgia in recurrent cases after microvascular decompression.
abstract: OBJECTIVE
  The objectives of this work are to report the outcomes of our finding during microvascular decompression (MVD) for patients with recurrent trigeminal neuralgia (TN) and to introduce the sling retraction technique.
  
  
  METHODS
  The authors performed a retrospective review of redo MVD for consecutive cases with recurrent TN after previous operation. Sling retraction techniques were used during the reoperation.
  
  
  RESULTS
  Fifteen patients underwent redo MVD. During the second operation, arachnoid adhesion of the Teflon felt was confirmed at the trigeminal nerve in 10 cases, and neurovascular conflict was found in 4 cases. Symptoms were completely relieved in 14 patients (93.3%) and partially relieved in 1 patient (6.7%). The mean follow-up period was 38 months (range, 21-60 months), and no patient experienced recurrence.
  
  
  CONCLUSIONS
  Arachnoid adhesion of the Teflon felt and vascular compression to the nerve were main causes of recurrence. The sling retraction technique is still an effective and useful treatment for recurrent TN after MVD.
authors.affiliation: From the Department of Neurosurgery, Suzhou Kowloon Hospital, Shanghai Jiaotong University School of Medicine, Suzhou, China.
authors.forename: De-bao
authors.initials: DB
authors.lastname: Yang
authors.forename: Dong-yi
authors.initials: DY
authors.lastname: Jiang
authors.forename: Han-chun
authors.initials: HC
authors.lastname: Chen
authors.forename: Zhi-min
authors.initials: ZM
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002681:China; D005260:Female; D006801:Humans; D008297:Male; D061145:Microvascular Decompression Surgery / Q000379:methods*; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery*; D012008:Recurrence; D012189:Retrospective Studies; D014277:Trigeminal Neuralgia / Q000601:surgery*