Trigeminal neuralgia: minimally invasive surgical treatment of trigeminal neuralgia

  Trigeminal neuralgia is a transient, recurrent paroxysmal pain in the distribution of the facial trigeminal nerve. It manifests as a burning, stabbing, cutting or tearing pain in the affected face. The pain does not usually go beyond the midline. Each attack may last from a few seconds to 1-2 minutes and then stop abruptly, with intervals as normal. The condition may gradually worsen and the number of pain attacks may become more frequent, even once a few minutes, so that it may last all day. The pain can be triggered by touching the skin of the patient’s face. In severe cases, patients dare not wash their faces, brush their teeth or even chew, and rely on a small amount of liquid or semi-liquid food to maintain nutrition throughout the day, which seriously affects the quality of life.  The trigeminal nerve is the nerve that controls the skin of the face, teeth and throat. Trigeminal neuralgia is a recurrent severe pain in the distribution area of the trigeminal nerve and is the most common among neurological pain disorders, occurring mostly in middle-aged and elderly people, more in women than in men. Most patients suffer from frequent and severe pain attacks as the disease progresses, so they are in great pain and spend their days in fear of the next attack, and may even have thoughts of “living lightly”. At the beginning of the disease, many patients mistakenly think that it is toothache and go to the stomatology department first, and some patients even have their teeth extracted for this reason, but the pain still cannot be relieved until it seriously affects their normal life.  Over the years, clinicians have explored a lot of trigeminal neuralgia, including closure, drugs, radiofrequency treatment, г-knife treatment, etc. However, they cannot remove the root cause of the disease, treat the symptoms but not the root cause, and are prone to recurrence. The current consensus on the etiology of primary trigeminal neuralgia is that the intracranial segment of the trigeminal nerve is compressed by abnormal blood vessels. Microvascular decompression can be performed with minimally invasive surgery to remove the root cause of the disease and achieve a cure. Traditional vascular decompression has a large incision, easy material slippage, and a high recurrence rate in the short postoperative period. The new method has the advantages of high efficacy, minimally invasive, and few complications.