• Rogelio Revuelta-Gutierrez, Jaime J Martinez-Anda, Juan Barges Coll, Aurelio Campos-Romo, and Nadia Perez-Peña.
• Department of Neurosurgery, Instituto Nacional de Neurologia y Neurocirugia, Universidad Nacional Autonoma de Mexico, Mexico City, Mexico.
• World Neurosurg. 2013 Sep 1;80(3-4):385-9.

ObjectiveTrigeminal neuralgia (TN) surgical treatment with microvascular decompression is highly effective and safe, but for a percentage of patients who undergo this procedure, no vascular compression is found. The purpose of this study was to evaluate the long-term efficacy with trigeminal root compression of the trigeminal nerve in patients with TN refractory to medical treatment who underwent neurosurgical management by a retrosigmoid approach of the cerebellopontine angle and were found to be negative for vascular compression.MethodsA prospective collection of clinical data on all patients with a diagnosis of idiopathic TN was conducted at our institution. A total of 277 patients with TN were treated by a keyhole retrosigmoid approach for exploration of the cerebellopontine angle between January of 2000 and August of 2010. A total of 44 patients were found to be negative for vascular compression of the trigeminal nerve; all of these patients underwent trigeminal root compression.ResultsWe found that all patients were pain free after the procedure. There was a 27% relapse in a mean time of 10 months, but 83% of these patients were adequately controlled by medical treatment, and only 17% needed a complementary procedure for pain relief. We also found that 63% of the patients complained of a partial loss of facial sensitivity, but only 1 patient presented with a corneal ulcer. There was a 6.7% rate of significant complications.ConclusionsWe concluded that trigeminal root compression is a safe and effective option for patients with primary TN without vascular compression.Copyright © 2013 Elsevier Inc. All rights reserved.

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