Microvascular decompression for trigeminal neuralgia caused by vertebrobasilar dolichoectasia: interposition technique versus transposition technique

• DOI: 10.1007/s00701-020-04572-7
• Publication Date: 2020-09-15T17:03:06Z
• Authors: Songshan Chai; Hao Xu; Qiangping Wang; Junjun Li; Jiajing Wang; Yihao Wang; Hendrik Pool; Minhua Lin; Nanxiang Xiong
• Keywords: Hypoesthesia; Microvascular Decompression; Transposition (logic); Interventional radiology; Hemifacial spasm

Various techniques of microvascular decompression have been proposed for trigeminal neuralgia (TN) caused by vertebrobasilar dolichoectasia (VBD) with two main modalities: interposition and transposition. This retrospective study compares the outcomes of two techniques belonging to different modalities for VBD-associated TN.From January 2011 to April 2017, 39 patients underwent MVD for VBD-associated TN. The transposition method chosen was the biomedical glue sling technique. Patients were divided into the interposition group (n = 16) and the transposition group (n = 23). The radiologic data, intraoperative findings, complications, and outcomes were analyzed.The 1-, 3-, and 5-year pain-free (BNI class I) maintenance rates were 100.0, 91.1, and 91.1%, respectively, in the transposition group and 87.5, 74.5, and 58.7% in the interposition group (p = 0.032). Postoperative complications were similar in both groups, but there was a trend for higher incidence of postoperative facial hypoesthesia using the interposition technique (p = 0.06).In cases of VBD-associated TN, the transposition technique using biomedical glue was superior to the traditional interposition technique in maintaining a pain-free status, with no increase in the incidence of complication.