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Updated: Jan 28, 2026
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Subcutaneous Trigeminal Nerve Field Stimulation for Refractory Facial Pain
Published on: May 10, 2017
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Trigeminal Neuralgia Due to Petrosal Bone Deformity
Sachiko Hirata1, Masahito Kobayashi1, Dai Kamamoto2
1Department of Neurosurgery, Saitama Medical University Hospital, Saitama, Japan.
World Neurosurgery
|March 5, 2019
Summary
This study details a rare case of trigeminal neuralgia caused by petrous bone deformity. Surgical decompression effectively relieved facial pain by addressing the bony compression of the trigeminal nerve.
Area of Science:
- Neurosurgery
- Neurology
- Anatomy
Background:
- Trigeminal neuralgia (TN) is a debilitating neuropathic pain condition.
- Bony structures causing TN are rare, with few reported cases.
- Petrous bone deformity is an uncommon etiology for trigeminal neuralgia.
Observation:
- A 43-year-old male presented with left-sided facial pain affecting the maxillary and mandibular divisions of the trigeminal nerve.
- Computed tomography revealed petrous bone hyperplasia compressing the left trigeminal nerve in the cerebellopontine cistern.
- Initial carbamazepine treatment provided unsatisfactory pain relief.
Findings:
- Microvascular decompression via the anterior transpetrosal approach was performed.
- Surgical drilling of the hyperplastic petrous bone relieved trigeminal nerve compression.
- Transposition of the superior cerebellar artery, potentially contributing to compression, was also performed.
- Complete resolution of facial pain was achieved post-surgery.
Implications:
- The anterior transpetrosal approach is a viable surgical strategy for TN secondary to petrous bone deformity.
- Addressing bony compression is crucial for treating this specific TN etiology.
- Successful surgical intervention highlights the importance of anatomical considerations in managing trigeminal neuralgia.
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