Abstract

Summary

To evaluate the effectiveness of modified microvascular decompression in classic trigeminal neuralgia.
 

Materials and Methods

The study included 16 patients with classic trigeminal neuralgia resistant to long-term carbamazepine therapy. The diagnosis was confirmed by clinical and neurological examination and MRI with 3D-TOF and FIESTA protocols. All patients underwent modified microvascular decompression via retrosigmoid access with vessel dislocation and combined isolation of the trigeminal nerve root (Teflon, Takahomb, adipose tissue).
 

Results

Complete regression of pain syndrome immediately after surgery was achieved in all 16 patients. The median BNI-PS score decreased from 4 [4-5] to 1 [1-1], and the median VAS score decreased from 7 [7-8] to 2 [2-2]; both differences were statistically significant (exact Wilcoxon signed-rank test, p<0.001). No disease recurrence was observed during the mean follow-up period of 1 year and 5 months.
 

Conclusion

Modified microvascular decompression with vessel dislocation and combined isolation of the trigeminal nerve root was associated with a statistically significant decrease in pain intensity and no registered recurrence during follow-up. Considering the small sample size, these results should be interpreted as preliminary evidence of the clinical effectiveness of the technique and require further confirmation in larger comparative studies.
 

Keywords

trigeminal neuralgia neurovascular conflict microvascular decompression.

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