Microvascular decompression for trigeminal neuralgia attributable to the vertebrobasilar artery: decompression technique and significance of separation from the nerve root

Impact of unilateral trigeminal neuralgia on bilateral ocular surface alterations

“…Moreover, idiopathic unilateral TN results in bilateral ocular abnormalities regardless of pain and operative procedures performed. [9][10][11] However, we do not have any hypothesis indicating the presence of both ipsilateral and contralateral DE and abnormal corneal cytology.…”

“…Therefore, even though pain is experienced unilaterally as the present study implies, idiopathic TN can be defined as a headache disorder with bilateral trigeminal nerve involvement. Moreover, idiopathic unilateral TN results in bilateral ocular abnormalities regardless of pain and operative procedures performed 9–11 . However, we do not have any hypothesis indicating the presence of both ipsilateral and contralateral DE and abnormal corneal cytology.…”

“…In a study of patients with TN conducted using corneal confocal microscopy (CCM), it was determined that patients with TN had significantly lower corneal nerve fiber density and corneal nerve fiber length compared with the control group 8 . However, no studies so far have found a direct link between DE and TN, although there are cases in the literature that present DE symptoms as a complication of microvascular decompression and stereotactic radiosurgery in patients with TN 9–11 . In those studies, it has been determined that the delivery of maximum‐dose radiation to the brain stem, the position of the isocenter relative to the exit of the trigeminal nerve from the brain stem, and the large volume of the brain exposed to radiation are important factors in the formation of DE complications.…”

Anterior transpetrosal approach for microvascular decompression associated with the dolichoectatic vertebrobasilar artery in two patients with refractory trigeminal neuralgia: Technical note

“…Although the rates have been declining recently, complications, such as hearing impairment (3.8-14%), still occur. [2,5,11] e retrosigmoid or far-lateral approach has been adopted in most MVD cases associated with the DVBA. is manipulation must be performed in a narrow corridor while paying attention to the facial and cochlea nerves (CN8).…”

“…However, MVD for DVBA is difficult to treat, and various approaches and vasculopexy methods have been reported. [ 4 , 5 , 9 , 10 , 14 ] We report two cases of successful transposition of the DVBA and a good postoperative course obtained using the anterior petrosal approach and a new vasculopexy method. An edited high-definition video with detailed subtitles is provided that illustrates this technique and its nuances [ Video 1 , Supplemental Digital Content].…”