Repeat Microvascular Decompression for Recurrent Trigeminal Neuralgia.

Introduction: Trigeminal neuralgia (TN) is described as the most excruciating pain typically involving the face. Microvascular decompression (MVD) is regarded as the established method of treatment of the condition. We aimed to detect the underlying pathology in recurrent TN cases, to prevent the recurrence rate of the patients and to determine the difficulties encountered during surgery.

Method: Forty four patients underwent recurrent MVD were retrospectively reviewed, analyzed and surgical nuances described. The following data were collected: age, sex, findings during surgery,TN length,used Teflon numbers, complications and associated comorbidities.

Result: In both male and female patient groups, excessive Teflon placement was the most common recurrence reason(p<0.005). In recurrent cases, it was statistically observed that there was a shortening in the length of the trigeminal nerve on the operation side. After following surgical routine, all Teflon related recurrent cases operated succesfully.

Conclusion: This study provide that detailed arachnoid dissection and efficient Teflon volume is crucial for trigeminal neuralgia success rate. To prevent recurrence; surgical landmarks, anatomical parameters, techniques and Teflon volume should be planned specifically.