Suboccipital Craniectomy: Retromastoid Approach for Trigeminal Neuralgia

Abstract

Microvascular decompression of the trigeminal nerve is the most frequently used open surgical procedure for the treatment of trigeminal neuralgia. It is most appropriate for patients with a 5-year expected survival who have had medically refractory trigeminal neuralgia for less than 8 to 10 years. The best results are obtained in patients who are neurologically intact without facial burning or numbness and in those who have not undergone a prior destructive procedure directed at the Vth nerve. The operation is carried out through a retromastoid suboccipital craniectomy, similar in many ways to the procedure described in chapter 25.