Endoscopic-assisted microvascular decompression for trigeminal neuralgia secondary to vertebrobasilar dolichoectasia: A case report

Duong, Ha Dai; Pham, Anh; Le, Tam Duc; Chu, Hung Thanh; Pham, Dung Tuan; He, Dong

doi:10.1016/j.ijscr.2021.105749

Cited by 4 publications

(3 citation statements)

References 11 publications

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“…Previously, only one case of endoscopic treatment of TN caused by VBA was reported. 12 In this article, we analyzed the clinical characteristics, treatment process, and postoperative outcomes of 26 patients with TN caused by VBA who were treated with E-MVD. The surgical strategies of E-MVD were analyzed in detail, and previous literature reporting on a group of patients (≥10) with TN caused by VBA was summarized and discussed.…”

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confidence: 99%

Fully Endoscopic Microvascular Decompression for Trigeminal Neuralgia Caused by Vertebrobasilar Artery: A Case Series Review: 2-Dimensional Operative Video

Sun,

Wang,

Jia

et al. 2023

Operative Neurosurgery

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BACKGROUND AND OBJECTIVE: Microvascular decompression (MVD) is the most definitive and preferred surgical treatment for trigeminal neuralgia (TN). Treatment of TN caused by the vertebrobasilar artery (VBA) has been reported to be challenging and less satisfactory in complications and recurrence. Endoscopy has been implemented to provide a comprehensive view of neurovascular conflicts and minimize brain tissue stretch injury while exploring the trigeminal nerve. However, there are few retrospective studies on the treatment of TN caused by VBA by fully endoscopic microvascular decompression (E-MVD). This article aimed to illustrate the safety and efficacy of E-MVD for TN caused by the VBA. METHODS: Clinical data for 26 patients with TN caused by the VBA who underwent E-MVD from 2019 to 2022 were retrospectively analyzed. The characteristics of vertebrobasilar-associated TN were summarized. The safety and efficacy of E-MVD for vertebrobasilar-associated TN were estimated based on the analysis of intraoperative manipulation, postoperative symptom relief, and complications. RESULTS: Intraoperatively, the vertebrobasilar artery was regarded as a direct offending vessel in all 26 patients with TN, the vertebral artery in 18 (69.23%) and the basilar artery in 10 (38.46%). In addition to the vertebrobasilar artery, other vessels involved included the superior cerebellar artery in 12 patients, anterior inferior cerebellar artery in 9, posterior inferior cerebellar artery in 1, and veins in 4. All patients underwent E-MVD, and TN was entirely resolved in 26 (100%) patients immediately postoperatively. During the follow-up period of 12–45 months, no recurrence or serious complications were found. There were no serious postoperative complications, such as cerebellar swelling, intracranial hemorrhage, or death. CONCLUSION: E-MVD for vertebrobasilar-associated TN is effective and safe.

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confidence: 99%

Fully Endoscopic Microvascular Decompression for Trigeminal Neuralgia Caused by Vertebrobasilar Artery: A Case Series Review: 2-Dimensional Operative Video

Sun,

Wang,

Jia

et al. 2023

Operative Neurosurgery

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“…The incidence of postoperative headache, hearing loss, and other complications is significantly lower than that after conventional MVD ( 54 , 71 ). Most importantly, in conventional MVD, the field of the microscope is severely limited, and it is difficult to identify the responsible vessels on the dorsal nerve ( 72 ). However, endoscopy provides a more optimized visualization effect for MVD; all possible pathogenic vessels can be found ( Figure 2 ) ( 38 , 54 , 73 ), and the detection rate of NVC is more reliable, avoiding insufficient decompression caused by missing the responsible vessels ( 74 , 75 ).…”

Section: Possible Improvement Of Mvd By Endoscopic Techniquesmentioning

confidence: 99%

“…These two imaging indicators reflecting neuropathy were close to the normal level, suggesting that EVD could improve the microstructure of the trigeminal nerve more effectively. Therefore, the advantages of EVD include shorter operation time, less surgical injury (external or internal), more effective surgical field of vision, and lower recurrence and complication rates ( 38 , 72 ). However, the premise of these improvements is that operators must be proficient in using endoscopes.…”

Section: Possible Improvement Of Mvd By Endoscopic Techniquesmentioning

confidence: 99%

Microvascular decompression: Diversified of imaging uses, advantages of treating trigeminal neuralgia and improvement after the application of endoscopic technology

Leng²,

Xia³

et al. 2022

Front. Neurol.

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Classical trigeminal neuralgia (CTN) is a unilateral and severe facial pain disease, which seriously affects the patient's quality of life. Microvascular decompression (MVD) is currently the most effective surgical method, and it is the only treatment for the etiology of CTN. Imaging for MVD has been increasingly used, and the advantages and disadvantages of endoscopy-assisted vascular decompression surgery have been controversially debated. In this review, we aimed to discuss the advantages of MVD in the treatment of patients with CTN, the importance of using imaging in disease management, and the improvements of vascular decompression surgery through the application and maturity of endoscopic techniques. Compared with other surgical methods, MVD has more prominent short- and long-term treatment effects. Its selection depends on the accurate discovery of neurovascular compression by preoperative imaging. Moreover, magnetic resonance imaging plays a diverse role in MVD, not only in identifying the responsible vessels but also in determining the prognosis and as a tool for scientific research. The use of endoscopic techniques provides improved visualization of the MVD and additional benefits for vascular decompression surgery.

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2021

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Endoscopic-assisted microvascular decompression for trigeminal neuralgia secondary to vertebrobasilar dolichoectasia: A case report

Abstract: Highlights Trigeminal neuralgia secondary to vertebrobasilar dolichoectasia is a rare condition. Endoscopic-assisted microvascular decompression is a safe and effective operation. Endoscopes allowed better visualization of REZ and neurovascular conflicts and least cerebellar retraction.

Cited by 4 publications

References 11 publications

Fully Endoscopic Microvascular Decompression for Trigeminal Neuralgia Caused by Vertebrobasilar Artery: A Case Series Review: 2-Dimensional Operative Video

Fully Endoscopic Microvascular Decompression for Trigeminal Neuralgia Caused by Vertebrobasilar Artery: A Case Series Review: 2-Dimensional Operative Video

Microvascular decompression: Diversified of imaging uses, advantages of treating trigeminal neuralgia and improvement after the application of endoscopic technology

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