Trigeminal neuralgia: microvascular decompression with partial posterior root rihzotomy: Assiut university experience

ABSTRACT

Microvasclar decompression [MVD] for treatment of trigeminal neuralgia [TN] is a well accepted method of treatment for confirmed cases with vascular compression of trigeminal root, adding partial posterior root rhizotomy to microvascular decompression or doing it alone in cases with negative exploration for vascular compression is a successful mean of treatment, with satisfactory long term outcome. 20 cases of trigeminal neuralgia were treated by retrosigmoid approach and exploration of the posterior root of the trigeminal nerve between March 2008 to December 2012 in the department of neurosurgery, Assiut university hospital Egypt. Patients were studied retrospectively, 17 patients found to have definite vascular compression over the posterior root and underwent microvascular decompression with adding posterior root rhizotomy 3 patients had negative exploration for vascular compression and had only partial rhizotomy of the posterior root of trigeminal nerve. All patients had definitive improvement after surgery, 18 cases stopped their usual medications and became pain free without need of medications, 2 cases had improvement of pain after surgery with the aid of medications. One patient had partial hearing loss with partial facial palsy after surgery which improved with physiotherapy after 3 months, the same patient had corneal ulcer and developed corneal opacity in one eye, 12 patients [60%] developed parasthia and numbness in the distribution of the trigeminal nerve, one patient had just wound infection. Adding rhizotomy to posterior root of trigemninal nerve could he a way, to improve the result of microvascular decompression and to treat cases without vascular compression