J Korean Neurosurg Soc.  2022 Sep;65(5):615-621. 10.3340/jkns.2021.0265.

Surgical Treatment for Trigeminal Neuralgia

• Park CK
• Park BJ

• KMID: 2533024
• DOI: http://doi.org/10.3340/jkns.2021.0265

Abstract

Various treatments for trigeminal neuralgia (TN) are known to yield initial satisfactory results; however, the surgical treatment has excellent long-term outcomes and a low recurrence rate. Surgical treatment addresses the challenge of vascular compression, which accounts for 85% of the causes of TN. As for surgical treatment for TN, microvascular decompression (MVD) has become the surgical treatment of choice after Peter J. Jannetta reported the results of MVD surgery in 1996. Since then, many studies have reported a success rate of over 90% for the initial surgical treatment. Most MVDs aim to separate (decompress) the culprit vessel from the trigeminal nerve. To increase the success rate of surgery, accurate indications for MVD and management of the offender vessels without complications are critical. In addition, if there is no vascular compression, partial sensory rhizotomy or internal neurolysis can be performed to improve surgical outcomes.

Keyword

Trigeminal neuralgia; Microsurgery; Rhizotomy; Microvasclar decompression; Neurosurgical procedures

Figure

• 

  Fig. 1. A : The superior cerebellar artery (SCA) is compressing the back side of the trigeminal nerve (TN) (white arrow). The veins also contact the anterior part of the TN (white arrowhead). B : Decompression of SCA was performed using Teflon (black arrow). C : The vein was also decompressed using Teflon (black arrowhead).

• 

  Fig. 2. A : The superior cerebellar artery (SCA) was compressed to trigeminal nerve (white arrow). B : Transposition of SCA was performed (white arrow).

Reference

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