Endoscopic neurovascular perspective in microvascular decompression of trigeminal neuralgia

Usefulness of the endoscope in microvascular decompression for trigeminal neuralgia and MRI-based prediction of the need for endoscopy

“…However, our results are comparable to the better half of what is published on conventional MVDs [1][2][3][4]13], and are similar to series on eaMVDs [10,27].…”

“…For the most part, better surgical outcome is attributed to an increased identification of neurovascular conflicts during surgery. On the other hand, many authors find similar surgical outcome with and without the aid of the endoscope, or do not compare their results to outcomes of conventional MVDs [10,27].…”

“…Hence, we could not delineate to what extent symptoms such as facial numbness, dizziness, hearing impairment, and tinnitus, were present prior to surgery, and to what extent it was aggravated by MVD. Many authors advocate the use of eaMVD or pure endoscopic vascular decompression on the basis of lower incidence of complications [6,17,[27][28][29], but others do not find a decline in the complication rates due to the inclusion of the endoscope [8,10].…”

“…Hence, accurate intraoperative visualization of the respective nerves and neurovascular conflicts (NVC), and verification of complete nerve decompression are crucial for surgical success. Recent reports indicate that the endoscope has an advantage over the microscope when it comes to visualizing the structures within the cerebellopontine angle (CPA), with the potential of better outcome at lower risk [6][7][8][9][10][11][12].…”

Anaesthesia for endoscopic neurosurgical procedures

“…Neuroendoscope is increasingly being applied to the treatment of other central nervous system diseases, such as in sylvian arachnoid cysts [53 ]; haematomas; brain abscess; cranial synostosis; cerebral aneurysms; acoustic neuromas; arteriovenous malformation; trigeminal neuralgia procedures [54]; CSF leaks [55]. When used in combination with image guidance and MRI the transnasal endoscopic approach can be used to localize and excise tumours such as anterior cranial fossa gliomas [56,57] and pituitary tumours [58 ].…”