Keisuke Onoda*, Tomoyuki Naito, Takahiro Kumono, Tomihiro Wakamiya, Yuhei Michiwaki, Tatsuya Tanaka, Takashi Agari, Takashi Sugawara, Kazuaki Shimoji, Eiichi Suehiro, Fumitaka Yamane, Hiroshi Itokawa and Akira Matsuno

Department of Neurosurgery, International University of Health and Welfare, School of Medicine, Narita Hospital, Japan

*Corresponding Author: Keisuke Onoda, Department of Neurosurgery, International University of Health and Welfare, School of Medicine, Narita Hospital, Japan.

Received: January 05, 2024; Published: February 14, 2024

Abstract

Background: Trigeminal neuralgia (TN) is caused by the compression of blood vessels against the trigeminal nerve. Microvascular decompression (MVD), in which blood vessels are moved to decompress the trigeminal nerve as a fundamental treatment, is the gold standard performed worldwide. In this study, we report our findings of reoperation and review the precautions for reoperation and procedures to prevent recurrence during the initial surgery.

Materials and Methods: Twenty-five patients (5%) who underwent surgery for recurrent TN among 498 cases of MVD in the past seven years were included. Pre- and post-operative evaluations were performed using the Barrow Neurological Institute (BNI) score. A detailed evaluation of complications was performed.

Results: Satisfactory results were obtained in 92% of the cases. Permanent neurological complications were not observed. The BNI-N evaluation revealed that five patients (20%) had grade I facial dysesthesia, two patients (8%) had very mild sensory disturbances (grade II), and one patient (4%) had moderate sensory disturbance (grade III).

Conclusions: Aggressive surgical treatment should be considered in patients with recurrent TN. To prevent recurrence, minimal Teflon felt and fibrin glue should be used during the initial surgery without bleeding.

 Keywords: Recurrence; Trigeminal Neuralgia; Microvascular Decompression

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Citation

Citation: Keisuke Onoda., et al. “Technical Nuances in Surgery for Recurrent Trigeminal Neuralgia”. Acta Scientific Neurology 7.3 (2024): 06-10.

Copyright

Copyright: © 2024 Keisuke Onoda., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.