<p><b>OBJECTIVE</b>To
report the clinical manifestations and the
revision surgery principles of recurrent
diseases of the posterior fossa nerves after primary
surgery.</p><p><b>
METHODS</b>Between 2000 to 2007, fourteen
patients with recurrent
diseases of the posterior fossa nerves in Shandong provincial
hospital were recruited in this study, all of whom were subjected to
revision surgery. The clinical manifestations and surgical findings were retrospectively reviewed.</p><p><b>RESULTS</b>Of the five
patients with recurrent
trigeminal neuralgia primarily, two underwent
microvascular decompression (MVD); the remaining three firstly received the II and III branches partial sensory
rhizotomy and, subsequently, the
pain reoccurred in the I branch distribution area. The remnant sensor fibre was resected in the
reoperation by which the sufferings were controlled completely in four of these
patients during 2 to 11 years of follow-up. In five
patients with
hemifacial spasm underwent re-exploration, there appeared obvious
fibrosis, conglutination, and the formation of new vessels around the
facial nerve, with which the result of
reoperation for this disorder was unsatisfied. In four
glossopharyngeal neuralgia patients, reanastomosis of the
glossopharyngeal nerve were found in two
patients, adhesion between the
glossopharyngeal nerve and the
vagus nerve was found in one
patient, but occurred in none of the another one. In the
revision surgery, the
regeneration of nerve fibre and two adjacent branches of
vagus nerve fibre were resected, with no occurrence during 2 to 5 years of follow-up. The pathological changes found in revision were severe adhesion between
cerebellum,
meninges, terylene slim and structures around. Also, the formation of new vessels,
cerebellum malacia, and
bleeding could be found in the
procedures.</p><p><b>CONCLUSIONS</b>The cause of recurrent of
trigeminal neuralgia and
hemifacial spasm are unclear. Recurrent
glossopharyngeal neuralgia may attribute to the
nerve fibers reanastomosis, adhesion or the communicating branches with
vagus nerve. With
respect to the
treatment of the
recurrence of
trigeminal neuralgia,
glossopharyngeal neuralgia after primary
surgery, the
effectiveness of nerve fibre resection is definite, whereas, the result of
revision surgery for
hemifacial spasm is poor.</p>