Posts Tagged ‘microvascular decompression’
Background: Trigeminal neuralgia (TN) is relatively frequent in multiple sclerosis (MS) patients and can be extremely disabling. Surgical interventions are less effective for the treatment of MS-related TN compared with classic TN, and higher recurrence rates are observed.
Objective: To evaluate initial pain-free response (IPFR), duration of pain-free intervals (PFIs), and factors predictive of outcome in different surgical modalities used to treat MS-related TN.
Methods: A total of 96 MS patients underwent 277 procedures (range, 1-11 procedures per patient) to treat TN at our institution from 1995 to 2011. Of these, 89 percutaneous retrogasserian glycerol rhizotomies, 82 balloon compressions, 52 stereotactic radiosurgeries, 28 peripheral neurectomies, 15 percutaneous radiofrequency rhizotomies, and 10 microvascular decompressions were performed as upfront or repeat treatments.
Objective: To assess the value of 3-D steady-state free precession imaging (SSFP) and time-of-flight magnetic resonance angiography (TOF MRA) in detecting the offending vessels in hemifacial spasm in comparison to intraoperative endoscopic visualization.
Methods: 42 patients underwent endoscope-assisted microvascular decompression (MVD). All available preoperative 3-D SSFP and TOF MRA images were checked. Intraoperative videos were captured by a high-definition endoscopic camera attached to endoscopes while exploring the area of facial nerve root exit zone (REZ). Evaluation of the 3-D images was performed by two independent groups of observers and compared with the operative findings.
Objective: We describe a transposition technique whereby a local pedicleddural flap, fashioned from the petrous posterior surface, is utilized to retract the offending vessel away from the root exit zoneof the facial nerve in hemifacial spasmcases.
Methods: We conducted a retrospective review of microvascular decompressionoperations in which the offending vessel was transposed and then retained by a localpedicleddural flap, made from the dura of the petrous posterior surface.