The minimally invasive retrosigmoid endoscopic-assisted microvascular decompression is an acceptable treatment of primary trigeminal neuralgia. Endoscopy provides a unique way to explore the cerebellopontine angle and to identify the exact location of the neurovascular conflict.

The principle of minimally invasive surgery in the cerebellopontine angle is gaining universal acceptance. The use of endoscopy in microvascular decompression for hemifacial spasm has helped tremendously in improving the results. In this study, the use of the endoscope enabled the authors to identify the site of the conflict in all cases, and to confirm the position of the Teflon sponge before closure.