Second microvascular decompression for trigeminal neuralgia in recurrent cases after microvascular decompression.

OBJECTIVES

The objectives of this work are to report the outcomes of our finding during microvascular decompression (MVD) for patients with recurrent trigeminal neuralgia (TN) and to introduce the sling retraction technique.

METHODS

The authors performed a retrospective review of redo MVD for consecutive cases with recurrent TN after previous operation. Sling retraction techniques were used during the reoperation.

RESULTS

Fifteen patients underwent redo MVD. During the second operation, arachnoid adhesion of the Teflon felt was confirmed at the trigeminal nerve in 10 cases, and neurovascular conflict was found in 4 cases. Symptoms were completely relieved in 14 patients (93.3%) and partially relieved in 1 patient (6.7%). The mean follow-up period was 38 months (range, 21-60 months), and no patient experienced recurrence.

CONCLUSIONS

Arachnoid adhesion of the Teflon felt and vascular compression to the nerve were main causes of recurrence. The sling retraction technique is still an effective and useful treatment for recurrent TN after MVD.