• Shih-Shan Lang, H Isaac Chen, and John Y K Lee.
• Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pa. 19104, USA. shihshan.lang@uphs.upenn.edu
• ORL J. Otorhinolaryngol. Relat. Spec. 2012 Jan 1; 74 (6): 293-8.

Background/AimsMicrovascular decompression (MVD) of the trigeminal nerve is a widely accepted treatment for patients with trigeminal neuralgia caused by vascular compression. The neuroendoscope is rapidly becoming a complementary tool in minimally invasive neurosurgery of the ventral anterior skull base. Its adoption in the lateral approach to the posterior fossa has been slower and has been used primarily as an adjunct to conventional microscopic surgical techniques, e.g. endoscope-assisted microsurgery.MethodsIn this paper, we describe a stepwise, technical commentary on a purely endoscopic MVD of the trigeminal nerve via the retrosigmoid route.ResultsFrom our experience, the endoscope provides excellent visualization of the neurovascular relationship. By allowing full visualization of the trigeminal nerve, endoscopy may likely lead to an increase in the number of successful MVDs and a decrease in the number of complications.ConclusionWe believe endoscopic MVD is a safe and effective method of accessing the trigeminal nerve in the cerebellopontine angle and of performing MVD. This endoscopic technique can be implemented in other neurosurgical and neuro-otological procedures such as resection of cerebellopontine angle masses.Copyright © 2012 S. Karger AG, Basel.

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