Repeat Microvascular Decompression for Recurrent Trigeminal Neuralgia.

Abstract

Trigeminal neuralgia (TN) is described as the most excruciating pain typically involving the face. Microvascular decompression is regarded as the established method of treatment of the condition. We aimed to detect the underlying disease in patients with recurrent TN, to prevent the recurrence rate of the patients and to determine the difficulties encountered during surgery. The cases of 44 patients who underwent recurrent microvascular decompression were retrospectively reviewed and analyzed and surgical nuances are described. The following data were collected: age, sex, findings during surgery, TN length, used Teflon numbers, complications, and associated comorbidities. In both male and female patient groups, excessive Teflon placement was the most common reason for recurrence (P < 0.005). In recurrent cases, it was statistically observed that there was a shortening of the trigeminal nerve on the operation side. After following the surgical routine, all patients with Teflon-related recurrence were operated on successfully. This study shows that detailed arachnoid dissection and efficient Teflon volume are crucial for the successful treatment of TN. To prevent recurrence, surgical landmarks, anatomic parameters, techniques, and Teflon volume should be planned specifically.