TRIGEMINAL NEURALGIA SURGERY
Dr. Hrayr Shahinian: Endoscopic vascular decompression for patients with trigeminal neuralgia or hemifacial spasm is performed through a dime-size opening behind the ear. A 2.7-millimeter endoscope is inserted into the posterior fossa and advanced to the cerebellopontine angle. The cranial nerves and vessels are identified - in this case, the patient with trigeminal neuralgia. The vessel is noted to be trapped underneath the trigeminal nerve. It is carefully lifted using micro-dissection techniques and instruments. A piece of Teflon is used to pad the nerve to prevent the vessel from being trapped underneath the nerve again. The dura is closed, the bone piece is repositioned and the 3-centimeter incision is re-approximated. The patient is discharged home within 24 to 48 hours.