gms | German Medical Science

59th Annual Meeting of the German Society of Neurosurgery (DGNC)
3rd Joint Meeting with the Italian Neurosurgical Society (SINch)

German Society of Neurosurgery (DGNC)

1 - 4 June 2008, Würzburg

Morbidity of microvascular decompression in patients with trigeminal neuralgia

Morbidität der mikrovaskulären Dekompression bei Trigeminusneuralgie

Meeting Abstract

  • corresponding author H. Kränzlein - Neurochirurgische Klinik, Universitätsklinikum Hamburg-Eppendorf, Hamburg
  • R. Borowka - Neurochirurgische Klinik, Universitätsklinikum Hamburg-Eppendorf, Hamburg
  • M. Westphal - Neurochirurgische Klinik, Universitätsklinikum Hamburg-Eppendorf, Hamburg
  • J. Regelsberger - Neurochirurgische Klinik, Universitätsklinikum Hamburg-Eppendorf, Hamburg

Deutsche Gesellschaft für Neurochirurgie. Società Italiana di Neurochirurgia. 59. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3. Joint Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch). Würzburg, 01.-04.06.2008. Düsseldorf: German Medical Science GMS Publishing House; 2008. DocMI.08.07

The electronic version of this article is the complete one and can be found online at:

Published: May 30, 2008

© 2008 Kränzlein et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: Microvascular decompression (MVD) in trigeminal neuralgia (TN) is believed to be the most effective treatment modality if patients have been carefully selected. Our own series was reviewed to evaluate the overall morbidity of MVD and its determinants as well as to answer the question as to whether a surgeon’s experience is a factor influencing the outcome of MVD. Between 1998–2007 a total of 80 patients were treated for trigeminal neuralgia by MVD. Postoperative complications were documented over a follow-up time of up to 5 years. The clinical course was correlated to patient age, prior treatment modalities and the surgeon’s experience.

Results: Following 80 MVD, there was one relapse in the first postoperative days due to dislocation of the Teflon-interposition which needed immediate reoperation. A CSF-fistula was seen in one patient where removal of petrous bone led to leakage into the paranasal sinus. Wound infection was diagnosed once. Clinical outcome with total pain relief was achieved in 73% but two required further therapies. Pain reduction was affirmed by 15 (18%) patients and two patients remained unchanged. Overall morbidity was 11% including temporary facial nerve palsy (7%), third nerve palsy, vertigo and deafness once each. Patient’s age (mean 63yrs.) and surgical experience (more than 8 yrs.) were not related to morbidity and clinical outcome but duration of preoperative symptoms (mean 69 months) and prior destructive treatments were found to be less favorable for MVD.

Conclusions: From our point of view, age is not an exclusion criteria per se and in experienced hands MVD remains the treatment of choice for any patient with the characteristic symptoms of TN. Unfavorable factors for MVD are still duration time of preoperative symptoms and prior destructive treatment forms. Therefore an early presentation of these patients would be desirable to improve the overall success rate of MVD.