• Xingqiang Gao, Weidong Qi, Ming Li, Jianning Zhang, Yi Cao, and Zhaoxin Ma.
• Department of Otolaryngology-Head and Neck Surgery, Xiamen First Hospital Fujian Medical College, China.
• Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2007 Jul 1; 21 (14): 643-5.

ObjectiveTo study the clinical valuation of different operation methods in treatment primary trigeminal neuralgia by retrosigmoidal approach.MethodThe clinical data of 165 cases with primary trigeminal neuralgia were studied, all head MRI(B-FFE) examination was made before surgery. According to patients' face sensation and cerebellopontine angle conditions, different operation methods were choose.ResultAmong of 165 cases, 7 cases with face numbness and sensory loss symptom before surgery, were treated with partial rhizotomy of trigeminal sensory root and nerve combing and all cured, followed-up study 3.5 to 5.0 years and no relapse and face sequelae is same as before; 145 cases with blood vessel compression and no face sequelae were treated with microvascular decompression and nerve combing of trigeminal nerve sensory root, 144 cases were cured and 1 case relieve, 15 cases with herpes simplex were cured after 1-2 weeks, 4 cases with oral lips or tongue numbness were cured after 1-3 months. Followed-up study 3 to 5 years,3 cases relapse and after second same operation methods cured. Among of 13 cases without face sequelae, 5 cases with artery compression were not suit to microvascular decompression and 8 cases without blood vessel compression. All these cases were treated with surface coagulation and nerve combing of trigeminal nerve sensory root, 2 cases with herpes simplex were cured after one week. Followed-up studying of 3.2 to 5.0 years, one case relapse, All 13 cases were cured and no neuralgia relapse and no severe sequelae. Among the 165 cases, two cases died of hemorrhage cephalon in operation or postoperation.ConclusionIt is a safe and effective way to choose different methods combine to treat primary trigeminal neuralgia according to patients' face sensation and cerebellopontine angle conditions, but the risk of operation should not be ignored.

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