Facial numbness in patients after surgery for vein associated trigeminal neuralgia

Chen Yinggao; Yu Wenhua; Yang Dingbo; Wang Hao; Zhang Jie

doi:10.11850/j.issn.1009-122X.2017.07.003

Abstract：Objective To investigate the surgical treatment of patients with trigeminal neuralgia associated with the superior petrosal vein and the causes and prevention of facial numbness after surgery. Methods Clinical data of 780 patients with primary trigeminal neuralgia were analyzed retrospectively. The patients were divided into simple vein type (n=49), arterial-venous mixed type (n=272), simple artery type (n=459) according to the superior petrosal vein-caused compression of the trigeminal nerve or not. The postoperative outcome and complications were compared among the three types. Results The recovery rates of simple vein type, arterial-venous mixed type and simple artery type were 93.88%, 98.90%, 98.91% respectively. And the facial numbness rates of simple vein type, arterial-venous mixed type and simple artery type were 73.5%, 46.3%, 30.5%respectively. The facial numbness rate was significantly higher in simple vein type and arterial-venous mixed type than in simple artery type (both P<0.05). Conclusions Facial numbness is one of the most common complications of trigeminal neuralgia after microvascular decompression. The rate of facial numbness is as follows: simple vein type higher than arterial-venous mixed type higher than simple arterial type. The full exposure of the cerebellar horizontal fissure and the trigeminal nerve root, protection of the petrosal vein, reduction of nerve and vessel traction are the effective means for decreasing incidence of facial numbness.