[Methods of reducing the number of complications and relapses after microvascular decompression in patients with trigeminal neuralgia]

Abstract

Techniques and methods of preventing the disease relapses and possible postoperative complications, e.g. vestibuloatactic syndrome, impairment or loss of hearing, paresis of the mimic muscles, syndrome of intracranial hypotension etc., are suggested on the basis of an analysis of results of 94 microvascular decompression operations of the trigeminal nerve root implemented in patients with trigeminal neuralgia. A contact with venous vessel is not a reason, according to the authors, of trigeminal neuralgia. The authors point out the need in a thorough revision of all surfaces of the trigeminal nerve root (but not only of its portal zone) for the purpose of detecting and removing all possible conflict points, which significantly reduces the number of possible disease relapses. The preservation of the petrosal vein and of its tributaries and, primarily, of the lateral inversion vein of ventricle IV is an important factor in preventing the postoperative vestibular-and-cerebellar disorders. The controllable exfusion of liquor, before opening up the dura matter of the brain, facilitates the approach to the neurovascular-conflict location by avoiding tension of the roots of cranial-and-cerebral nerves. The autoliquortransfusion, made at final operation stage, ensures the recovery of the intracranial pressure to normal values, thus, preventing a possible hypotensive syndrome and hydrops labyrinthine, which can lead to an impaired hearing and vestibuloatactic syndrome.