MICROVASCULAR DECOMPRESSION OF CRANIAL NERVES IN TREATMENT OF FACIAL PAIN

Yu.A. Shuliov, N.V. Shuleshova, M. Maclaklin, O.V. Bolshakova, V.N. Bikmullin, A.V. Vorobiov, V.V. Rudenko

Municipal Neurosurgical Center attached to Municipal Multi-field Hospital N2, Chair of Neurosurgery of the Saint Petersburg Medical Academy of Postgraduate Education, Chair of Nervous Diseases and Neurosurgery of the Saint Petersburg Pavlov State Medical University

The first experience of surgical treatment of 11 patients with facial pain is analyzed. Their age and disease duration varied from 35 up to 82 years and from a year up to 30 years respectively.

A diagnostic complex included MRI and CT examinations, eletromyography and cerebral angiography which was used in some cases. It is known that one of the etiological factors of facial pain is compression of cranial nerves by a pulsating cerebral vessel (superior cerebellar artery, inferior anterior and posterior cerebellar arteries, diploic veins). Taking into account this fact, the authors performed microvascular decompression of the trigeminal nerve (10 cases) and the trigeminal and glossopharyngeal nerves (1 case). Excellent (complete regress of a pain sydrome), good (pain relief of 50-80%) and bad (pain relief of 10%) results were obtained in 8, 2 and 1 case respectively.

The authors’ experience allows to consider microvascular decompression to be an effective means of treatment of facial pain.