Full endoscopic vascular decompression in trigeminal neuralgia: Experience of 230 Patients.

Full endoscopic vascular decompression in trigeminal neuralgia: Experience of 230 Patients.

World Neurosurg. 2018 Feb 24;:

Authors: Dubey A, Yadav N, Ratre S, Parihar VS, Yadav YR

Abstract
BACKGROUND: Although most surgeons are employing endoscope as an adjunct to the microscope in microvascular decompression, a full endoscopic technique is less commonly performed. The present study is aimed to evaluate results of 230 patients of endoscopic vascular decompression.
METHODS: A retrospective study was carried out in a tertiary care hospital. Patients with typical neuralgia, with or without preoperatively detected vascular compression, were advised to undergo vascular decompression.
RESULTS: Maxillary and mandibular division were involved in 116, and 93 patients respectively. Superior cerebellar (n=174) artery was most common vascular conflict followed by anterior inferior cerebellar artery (n=96). Tortuous basilar artery and small veins were possible causes of neuralgia in 1 and 2 patients respectively. Single and double vessels conflict was observed in 173 and 50 patients respectively. The compressing vessel was placed anterior to the trigeminal nerve in 39 patients. An arterial loop was in contact with the nerve, producing grooving, and displacing the nerve in 215, 35 and 21 patients respectively. Complete, satisfactory and no relief of pain was observed in 204 (88.7%), 11 (5.8%) and 15 (6.5%) patients respectively. Recurrence was observed in 25 patients at an average 60 months follow up. Temporary complications included trigeminal dysesthesia, vertigo, facial paresis, CSF leak, and reduced hearing in 9, 8, 8, 7, and 3 patients respectively.
CONCLUSION: Endoscopic vascular decompression is a safe and efficient alternative technique to endoscopic assisted microvascular decompression provided surgeon is experienced in endoscopic surgery. It is helpful in identification of all offending vessels including the double vessel, and anterior compression without brain and nerve retraction.

PMID: 29486313 [PubMed - as supplied by publisher]

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