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Application of transcerebellar horizontal fissure cerebellopontine fissure approach in trigeminal microvascular decompression |
LV Bo1, HAN Yipeng2 |
1. Department of Neurosurgery, the First Affiliated Hospital of Anhui Medical University, Hefei 230022,China; 2. Department of Neurosurgery, Chinese PLA General Hospital, Beijing 100853, China |
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Abstract Objective To investigate the application of transcerebellar horizontal fissure cerebellopontine fissure approach in microvascular decompression for trigeminal neuralgia.Methods Seventy-two patients with trigeminal neuralgia treated in the department of neurosurgery of the First Affiliated Hospital of Anhui Medical University from March 2018 to October 2020 were divided into the cerebral fissure group which were treated with transcerebellar horizontal fissure cerebellopontine fissure approach and the normal group which were treated with normal lateral cerebellar approach. The incidence and effect of intraoperative rupture or disconnection of petrosal vein were compared between the two groups.Results There was no intraoperative petrosal vein rupture or cut-off in the cerebral fissure group. There were 6 cases of petrosal vein rupture (16.7%) and 6 cases of intraoperative cut-off (16.7%) in the normal group. The incidence of intraoperative petrosal vein rupture or cut-off in the cerebral fissure group was lower than that in the conventional group, and the difference was statistically significant (P<0.05); There was no significant difference between the two groups in curative effect (χ2=6.063,P=0.109); But the cure rate of cerebral fissure group was higher than that of normal group, and the difference was statistically significant (χ2=5.171,P=0.023). After 6 months of follow-up, the recurrence rate (0) of cerebral fissure group was lower than that of routine group (18.75%). The difference was statistically significant (P<0.05).Conclusion In microvascular decompression for trigeminal neuralgia, the transcerebral horizontal fissure cerebellopontine fissure approach can reduce the risk of intraoperative petrosal vein rupture or disconnection, and the cure rate and recurrence rate 6 months after operation are better than the conventional approach.
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Received: 15 February 2022
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