gms | German Medical Science

Objective: Microvascular decompression (MVD) for trigeminal neuralgia (TN) is a safe and recognized treatment for TN after unsuccessful medical treatment. The aim of our study was to determine the incidence of early and delayed facial nerve palsy (FNP) after MVD and their gradients.

Method: 153 patients with TN were operated in our hospital between January 2007 and December 2013. The preoperative status, including magnetic resonance imaging (MRI) was collected, follow-up examinations were performed immediately postoperatively, at discharge, after 3 and 6 months. Further follow-up will be done.

Results: In one patient a facial palsy was noted prior to surgery. It resolved post-operatively, an anatomical correlate was not found. Two patients (1.3%) developed facial palsy immediately after surgery. In the first case it improved over time, the 2^nd case was lost to follow-up as the patient moved abroad. In two other cases (1.3%) a delayed FNP was observed 12 and 16 days after surgery (House and Brackman VI and IV), each with complete remission after 4 weeks.

Conclusions: Facial nerve palsy is a rare complication after MVD for trigeminal neuralgia. Most vulnerable are patients with recurrent intervention and/or difficult anatomical sites. In all 3 patients, who could be followed-up on, the FNP disappeared completely, in the cases of delayed FNP within 4 weeks. Although in the literature, no case of delayed FNP after MVD for trigeminal neuralgia has been described, we should inform the patients about this possibility prior to surgery.