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Updated: Aug 15, 2025
Microvascular Decompression: Salient Surgical Principles and Technical Nuances
Published on: July 5, 2011
Anterior transpetrosal approach for microvascular decompression associated with the dolichoectatic vertebrobasilar
Masafumi Segawa1, Tomohiro Inoue1, Sho Tsunoda1
1Department of Neurosurgery, NTT Medical Center Tokyo, Shinagawa City, Tokyo, Japan.
Background:
Trigeminal neuralgia (TN) due to compression from the dolichoectatic vertebrobasilar artery (DVBA) is extremely rare and difficult to treat due to its morphological characteristics. We report two cases of good transposition of DVBA and postoperative course obtained using the anterior petrosal approach and a new vasoculopexy method.
Methods:
We describe two cases of microvascular decompression (MVD) for refractory TN associated with DVBA. In both cases, MVD was performed through the anterior petrosal approach. The DVBA was decompressed using a GORE-TEX sling and WECK clip in an inferomedial direction.
Results:
Complete pain relief without new neurological deterioration was achieved immediately in both patients.
Conclusion:
We experienced a rare condition of TN due to exclusion by the DVBA. The anterior transpetrosal approach was extremely effective in this case. This approach secured the surgical field, allowed transposition of the DVBA, and caused no perioperative complications.
