Microvascular decompression treatment for trigeminal neuralgia.

PURPOSE The purpose of the study was to evaluate the effectiveness of microvascular decompression treatment prospectively in 40 patients with trigeminal neuralgia who were resistant to medical treatments and underwent microvascular decompression surgery (MVDS) between the years 2008 and 2010. METHODS The patients' data were collected as per norms suggested by Zakrzewska and Lopez and followed up using annual trigeminal neuralgia survey given by Zakrzewska et al, through direct interview during follow-up visits. Patients were operated on in supine position with lateral suboccipital surgical approach. RESULTS Forty patients with a mean age of 48 (SD, 13) years underwent surgery. The etiological factors were estimated as idiopathic or vascular compression in 39 patients and epidermoid tumor in 1. During the postoperative period of 8 to 46 months, 37 (92.5%) of the patients were pain-free without any further medical treatment. CONCLUSIONS Our result supports the notion that MVDS is the treatment of choice for patients with trigeminal neuralgia. Pure MVDS can offer long-term cure rate of more than 98% of success for neuralgia in the presence of clear-cut and marked vascular compression at surgery.