Treatment of Trigeminal Neuralgia with "Microvascular Decompression Plus" Technique.

Although microvascular decompression (MVD) has been widely accepted as an effective treatment of trigeminal neuralgia (TN), some patients have not been cured. To improve the postoperative outcome, the surgical procedure should be further refined.  This is a retrospective study.  Present study conducted at a cranial nerve disorder center.  Clinical data were collected from patients with TN who had undergone surgery in our center, including 685 who had undergone traditional MVD and 576 who had undergone the "MVD plus" procedure, in which any vessel attached to the trigeminal nerve was freed away ("nerve-combing"), which was followed by intraoperative neurolysis.  Postoperative outcomes and complications in the two groups were compared.  Among patients who underwent traditional MVD, the rates of immediate relief and 1-year relief were 89.9 and 86.9%, respectively; among patients who underwent MVD plus group, these rates were 95.1 and 94.6%, respectively (  = 0.05). Patients who underwent MVD plus initially exhibited a higher rate of facial numbness (  < 0.05), but this finding decreased over time and reached the same level as that in the traditional MVD group within 3 months (  > 0.05).  Sufficient MVD with nerve-combing for the treatment of TN may produce a high rate of cure with less recurrence.