Abstract:

 Objective   The aim of the study was to describe and evaluate the efficacy of the keyhole microsurgery to manage patients with trigeminal neuralgia (TN),  hemifacial spasm (HFS) and glossopharyngeal neuralgia (GPN). Methods   Two hundred and seven patients underwent microvascular decompression (MVD) and neurotomy via retrosigmoid keyhole approach in our department clinic: MVD for trigeminal neuralgia 169 cases,  hemifacial spasm 31 cases,  glossopharyngeal neuralgia 4 cases and neurotomy for glossopharyngeal neuralgia 3 cases. There was no serious complication such as deaths or infarction in the cerebellum or the brainstem. Results  Complete and partial symptoms relief was obtained in 160 (94.7%) cases and failure 9 (5.3%) cases with MVD for trigeminal neuralgia, postoperatively. Meanwhile,  complications occurred in one  case with cerebellar hematoma only. The postoperative results of MVD for hemifacial spasm with symptoms relief was noted in 29 (93.5%) cases and failure 2 (6.5%) cases. Postoperative complications occurred in one case with moderate hearing loss,  another three cases complained of transient facial paralysis. Symptoms relief achieved in all 7 (100%) cases undergone MVD or neurotomy for glosspharyngeal neuralgia. Postoperative complications occurred in  one case with moderate vocal paralysis. Conclusion   We think that microsurgery via retrosigmoid keyhole approach is safe and eVective for CPA hyperactive  cranial nerve dysfunction syndromes.

Key words: Retrosigmoid approach；Craniotomy；Microsurgery；Microvascular decompression；NeurotomyJannetta