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  • Title: Efficacy and safety of root compression of trigeminal nerve for trigeminal neuralgia without evidence of vascular compression.
    Author: Revuelta-Gutierrez R, Martinez-Anda JJ, Coll JB, Campos-Romo A, Perez-Peña N.
    Journal: World Neurosurg; 2013; 80(3-4):385-9. PubMed ID: 22889619.
    Abstract:
    OBJECTIVE: Trigeminal neuralgia (TN) surgical treatment with microvascular decompression is highly effective and safe, but for a percentage of patients who undergo this procedure, no vascular compression is found. The purpose of this study was to evaluate the long-term efficacy with trigeminal root compression of the trigeminal nerve in patients with TN refractory to medical treatment who underwent neurosurgical management by a retrosigmoid approach of the cerebellopontine angle and were found to be negative for vascular compression. METHODS: A prospective collection of clinical data on all patients with a diagnosis of idiopathic TN was conducted at our institution. A total of 277 patients with TN were treated by a keyhole retrosigmoid approach for exploration of the cerebellopontine angle between January of 2000 and August of 2010. A total of 44 patients were found to be negative for vascular compression of the trigeminal nerve; all of these patients underwent trigeminal root compression. RESULTS: We found that all patients were pain free after the procedure. There was a 27% relapse in a mean time of 10 months, but 83% of these patients were adequately controlled by medical treatment, and only 17% needed a complementary procedure for pain relief. We also found that 63% of the patients complained of a partial loss of facial sensitivity, but only 1 patient presented with a corneal ulcer. There was a 6.7% rate of significant complications. CONCLUSIONS: We concluded that trigeminal root compression is a safe and effective option for patients with primary TN without vascular compression.
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