Microsurgical decompression of cranial nerves

Grigoryan Yu. A., Sitnikov A. R.

Keywords: hemifacial spasm, microsurgical decompression, trigeminal neuralgia, vagoglossopharyngeal neuralgia

Objectives: to analyse the intra-operative findings and results of microsurgical decompression among the patients with vascular or tumour-related compression of caudal cranial nerves.

Materials and methods: 191 patients were operated applying the method of microsurgical decompression. Surgery was performed via retromastoidal approach with following transposition of intracranial vessels or tumour resection and implantation of various protective systems between the vessels, cranial nerves and brain stem.

Results: 170 patients had trigeminal neuralgia (TN), 16 – hemifacial spasm (HS) and 5 - vagoglossopharyngeal neuralgia (GPN). The vascular compression was observed in 180 patients; the compression by tumour in 11 patients. In most of the cases of TN the compression was due to superior cerebellar artery or its brunches, occasionally due to anterior inferior cerebellar artery or basilar artery. Among the patients, suffering from HS and GPN compression resulted from basilar artery, anterior inferior and posterior inferior cerebellar arteries. The compression by tumour was found in 10 cases of TN and in one case of HS. After the surgery about 99% of patients had good outcomes. The pain relapsed in 5% of patients following by the re-operation.

CONCLUSION: the microsurgical decompression of nerves roots is the highly effective method of surgical treatment, characterised by the remaining of nerves functions and low re-occurrence rate.

Black sea Neurosurgical congress, 1 – 3/10/2007 Olginka, Krasnodar area, Russia, Сборник тезисов, c. 83