Abstract: | Selective section of the posterior root of the trigeminal nerve was performed 42 times on 41 patients over the past 5 years. Twenty-eight retrolabyrinthine procedures for the selective section of the posterior root of the trigeminal nerve were performed for typical tic douloureux with complete lasting relief in 25; 1 was relieved with the addition of aspirin; and 2 were relieved by Tegratol, even though it was ineffective before surgery. Of 8 patients with atypical trigeminal neuralgia, 5 required subsequent surgery for treatment of geniculate neuralgia before relief was obtained. Two patients with atypical pain continued their discomfort despite surgery. Selective Vth nerve section was accomplished during translabyrinthine approach in 5 cases with acoustic neuroma and 1 during VIIIth nerve section and facial nerve decompression. There were no deaths and no serious complications. None had facial paralysis or anesthesia dolorosa resulting from the nerve section. The retrolabyrinthine approach to the posterior root of the trigeminal nerve is ideally suited for those patients with refractory tic douloureux or patients with facial pain secondary to other causes such as tumor. Because of its effectiveness and low morbidity this procedure offers advantages over other surgical techniques. |