Microvascular decompression as a surgical management for trigeminal neuralgia: long-term follow-up and review of the literature

This retrospective study summarizes our experience based on treating 62 patients with trigeminal neuralgia treated with microvascular decompression. All patients had typical trigeminal neuralgia symptoms, with 24 of them (38%) having failed to benefit from other previous treatment paradigms. We excluded subjects with atypical and/or secondary forms of trigeminal neuralgia. Follow-up duration ranged from 5 months to 10 years 6 months, with recurrence being identified in three patients (4.8%).We found that the superior cerebellar artery is the leading offending vessel in our cases (33.9%; 21 patients). Interestingly, seven patients (11.3%) underwent an early reoperation 12-48 h later after the first operation was deemed ineffective. This subgroup recovered satisfactorily following isolation of the pathogenic vessels. Overall, no mortality was observed in our patients, and the only permanent morbidity outcome was a case of facial nerve palsy (1.6%). We conclude that microvascular decompression and its reapplicaiton for patients who showed no pain relief immediately after the first decompression are safe and effective treatments for trigeminal neuralgia.