TREATMENT OF TRIGEMINAL NEURALGIA BY POSTERIOR-FOSSA MICROVASCULAR DECOMPRESSION

A series of 109 cases of microvascular decompression for intractable t rigeminal neuralgia was reviewed. Operations were performed by a singl e surgeon and cases were reviewed independently by the one author. The failure rate in this study was 17.6%. A further 6.5% of cases endured brief recurrences not requiring treatment. Two-thirds of significant recurrences occurred within the initial 12 months. Long-term complicat ions were experienced in 7.4% of cases. There was one postoperative mo rtality occurring in a patient with a large fibroblastic meningioma in vading the brain stem. The classic Jannetta approach was modified foll owing the first 32 cases allowing the cerebellum to be depressed infer iorly with a subsequent decline in the rate of loss of hearing from 12 .5 to 3.7%. In over 70% of cases an aberrant superior cerebellar arter y was found compressing the fifth cranial nerve. Patients had dental w ork performed in an attempt to control the pain prior to operation in 44% of cases.