[Trigeminal neuralgia. Results of microsurgical parapontine decompression]

In typical trigeminal neuralgia lasting painlessness can be obtained in 85-90% of all cases by microsurgical decompression of the nerve at the pons. Generally neurological deficits of the trigeminal nerve are not observed after surgery. The method has a favourable effect on many cases of secondary atypical neuralgia too, at least respective the tic douloureux. The follow-up period runs up to several years in most of our 151 cases. In about 5% of these cases recurrence of the neuralgia takes place, for the most part within the first year. The most frequent surgical complication is damage to the acoustic nerve (bradyacousia or deafness), which occurs in about 8% of cases. The over-all surgical mortality is 1.0-1.5%. In every case of typical trigeminal neuralgia there is an indication for microsurgical decompression of the fifth cranial nerve at the pons, provided pharmacotherapy has proved ineffective and anaesthesia carries no increased risk due to old age or ill-health.