THE PIVOTAL ROLE OF CRANIAL NERVER DECOMPRESSION

Reported are a total of 81 microsurgical operations for cranial nerve root decompression comprising of 66 trigeminal, 10 facial, one vestibular, one vagus and three accessory nerve dysfunction syndromes from 1983 to 1990. Almost all cases of trigeminal neuralgia (TNG) secondary to vascular (59 cases) and minute mass (10 cases) compression, and those with hemifacial spasm (HFS) (nine out of 10 cases) recovered with microsurgical decompression of these nerves. A comparison of results of different treatment modalities of TNG are discussed. Some recently reported series in the literature indicate the superiority of microvascular decompression (MVD) of the 5th nerve for the treatment of TNG. MVD of the 7th nerve has currently been accepted as a procedure of choice, albeit with reservations, in managing HFS. Despite our effective surgical outcome and satisfactory results obtained by others with MVD of the 8th, 10th and 11th nerves, long-term follow up of selected cases may further clarify the r9le of MVD on caudal cranial nerves.