Treatment of patients with common cranial nerve diseases by microvascular decompression v/a a posterior sigmoid sinus key hole approach： a report of 211 cases

Abstract

Objective To explore the incidence of operation complications and clinical curative effect of microsurgical vascular decompression on treatment of patients with common cranial nerve diseases. Methods One hundred and sixty-six patients with hemifacial spasm and 45 patients with primary trigeminal neuralgia, admitted to our hospital from September 2006 to May 2011, were collected in our study; all the patients underwent microvascular decompression via a posterior sigmoid sinus key hole approach. Complications were analyzed after surgery for trigeminal neuralgia and hemifacial spasm patients to find the difference on complications between these 2 diseases. And at least 3-month clinical follow-up after microvascular decompression surgery was carried out to note the differences on disappearance of cranial nerve symptoms between 3 d and 3 months after the surgery. Results Postoperative fever in the patients with hemifacial spasm and trigeminal neuralgia was seen in 51 and 14 patients, prosopoplegia in 7 and 1 patient, hearing impairment in 4 and 2 patients, incisional cerebrospinal fluid leakage in 5 and 2 patients, and intracranial infection in 3 and 2 patients, respectively. Symptom disappearance was noted in 109 patients with hemifacial spasm 3 d after the surgery and in 153 patients 3 months after surgery with a cure rate up to 92.2%; 44 patients with disappearance of symptoms during the 3rd d to the 3rd months of surgery had delayed healing. The symptom disappearance was observed in 40 patients with trigeminal neuralgia 3 d after the surgery and in 42 patients 3 months after the surgery, with a cure rate reaching 93.3%. Conclusion No significant difference in the incidence of operation complications is noted between patients with trigeminal neuralgia and hemifacial spasm treated by microvascular decompression via posterior sigmoid sinus key hole approach; the surgery enjoys exact effectiveness： and postoperative patients with hemifacial spasm may gradually get recovery in a short term. Key words: Hemifacial spasm;  Trigeminal neuralgia;  Microvascular decompression;  Posterior sigmoid sinus approach