[Microvascular decompression of the trigeminal nerve - a causal therapy of trigeminal neuralgia?]

Preliminary experiences with the microvascular decompression of the trigeminal nerve within the cerebello-pontine angle ("Jannetta's operation") in ten patients are reported. All nine patients with typical tic douloureux were found to have a cross-compression of the nerve by the superior cerebellar artery. This vessel was separated from the nerve and held in place by a piece of Gelfoam. All nine patients were painfree immediately following surgery. Their sensation within the trigeminal area was unchanged compared to the preoperative state. The remaining patient suffered of atypical facial pain and did not reveal a cross-compression of the trigeminal nerve neither by an artery nor by a vein. Microvascular decompression seems to be a causal therapy in trigeminal neuralgia and is a non-destructive operation. Although our period of postoperative observation is short (up to five months), the results are very promising and correspond to the experiences reported by other authors. Advantages and disadvantages compared to the radiofrequency lesion (electro- and thermocoagulation) of the trigeminal nerve are discussed.