Surg Neurol
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Posterior fossa exploration in treatment of trigeminal neuralgia associated with multiple sclerosis.
The possible surgical options during PFE in treatment of TN in patients with MS are MVD and PSR. Only sporadic cases of PSR in treatment of TN patients with MS have been reported. ⋯ In our experience, MVD + PSR or PSR alone are safe and effective surgical procedures in the management of TN complicating MS. In MVD + PSR patients, PSR seems to play more significant role than MVD in pain relief. Since there were not severe neurovascular conflicts in our patients with MS, MVD alone was never justified.
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We report our experience with the Aesculap Pneumatic Powered Kerrison Rongeur (Aesculap AG Company) Tuttlingen, Germany. ⋯ The new pneumatically powered Kerrison rongeur not only is safe and easy to use but also virtually eliminates the manual fatigue and, at times, pain associated with prolonged bone removal from the use of standard Kerrison rongeurs.
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The physiologic tremor may cause difficulties in microsurgery, in spite of using armrest. The new (robot hand) technique consists of the I-III finger support, which holds the instruments on Bethlehem (ANDAN BT, Budapest, Hungary) bridge above the operation area, which reduces the tremor at the end of the instruments. ⋯ By this technique, the microsurgical work has become more precise.