Cohen-Gadol Aaron A
Goodman Campbell Brain and Spine, Indiana University Department of Neurological Surgery, Indianapolis, IN 46202, USA.
Clin Neurol Neurosurg. 2011 Dec;113(10):844-53. doi: 10.1016/j.clineuro.2011.06.003. Epub 2011 Jul 14.
Microvascular decompression (MVD) surgery for trigeminal neuralgia and hemifacial spasm offers a relatively low-risk opportunity to treat cranial nerve hyperactivity-compression syndromes, which are associated with severe, disabling facial pain and spasm. Although a number of publications have described the technique in detail, combining the technical nuances from different schools of thought or neurosurgical training in an effort to increase the safety and efficacy of this procedure would be beneficial to the surgeon.
The nuances of technique and operative findings from performing this procedure for the last 100 cases have been reviewed and combined. The author has reflected on his experience performing microvascular decompression operation.
The specifics of operating room set-up, positioning, craniotomy, and intradural microsurgical methods are provided, including managing postoperative care and complications.
In the presence of alternative methods of therapy, microvascular decompression operations should be performed with low risk to the patient. There is a learning curve involved with this operation and the surgeon should remain always critical of his/her performance and aspire for a "perfect" result.
微血管减压术（MVD）用于治疗三叉神经痛和半面痉挛，为治疗与严重致残性面部疼痛和痉挛相关的颅神经功能亢进-压迫综合征提供了相对低风险的机会。尽管有许多出版物详细描述了该技术，但结合不同思想流派或神经外科培训中的技术细微差别，以提高该手术的安全性和有效性，将对外科医生有益。
回顾并结合了过去100例实施该手术的技术细微差别和手术发现。作者反思了自己进行微血管减压手术的经验。
提供了手术室设置、体位、开颅手术和硬膜内显微手术方法的细节，包括术后护理和并发症的处理。
在存在替代治疗方法的情况下，微血管减压手术应以低患者风险进行。该手术存在学习曲线，外科医生应始终对自己的表现保持批判性，并追求“完美”结果。
