Trigeminal neuralgia is a syndrome of chronic facial pain which severely affects quality of life. Although it usually begins as a relapsing disease, with pain-free intervals lasting months or years, these intervals grow shorter and ultimately disappear. As the disease progresses, patients can have difficulty talking, eating and maintaining facial hygiene. Although many patients are successfully treated with medication, some require operations because drugs are ineffective or because their side effects are intolerable. About half of patients who do suffer with trigeminal neuralgia may eventually require surgical treatment.
Microvascular decompression preserves the trigeminal nerve.
The procedure involves a small opening in the skull behind the ear, microsurgical examination of the trigeminal nerve and repositioning of any compressive arteries, with a small protective pad placed between the nerve and the artery. If the blood vessel pressing on the nerve is a vein, it may treated by removal or by being moved and separated from the nerve as arteries are. Other surgical approaches cause controlled injury to the trigeminal nerve, ganglion or root, often resulting in facial numbness. The study shows the procedure to be extremely safe and effective, with excellent quality of life but not numbness. Dr. Jannetta says microvascular decompression is a center-oriented procedure demanding special training and experience to keep the procedure extremely safe.