Management Of Petrosal Vein In Microvascular Decompression For Primary Trigeminal Neuralgia

Objectives:To observe the characteristics of petrosal vein and the relation with operative approach and explore the management of petrosal vein and its branches during microvascular decompression for primary trigeminal neuralgia.Methods:The clinical data of 62 cases with trigeminal neuralgia were treated with microvascular decompression from September 2013 to September 2015 in The First Affiliated Hospital of Kunming Medical University were analyzed retrospectively, including the clinical symptoms of the 62 cases, the trunks and the braches of SPV, how much were sectioned, and the surgery outcome and complications. To analyze the effect of the surgery complications in two groups with whether the petrosal vein was cut. And summarizing the management of petrosal vein and its branches during microvascular decompression for primary trigeminal neuralgia.Results:The 62 primary trigeminal neuralgia patients were found the petrosal veins. In 16 patients (25.8%), the surgical approach or field was obstructed by the trunk of the superior petrosal veins, and which should be cut in 7 cases (11.3%). the surgical approach or field was obstructed by the branches of the superior petrosal veins in 29 patients (46.8%), and which should be cut in 14 cases (22.3%). Trigeminal nerve comperession by the superior petrosal vein was observed in 7 patients (11.3%), and 3 case (3.3%)was cut. In 10 patients (16.1%), the surgical approach or field had no sbstruction form the superior petrosal vein during the operation. In this study, the superior petrosal vein was cut in 24 cases, which had transient hearing disturbance in 5 case, facial numbness 2 case. One patient encountered cerebeuar infarction; the superior petrosal vein wasn’t cut in 38 cases, which had transient hearing disturbance in 3 case, facial numbness 2 case.Conclusions:Petrosal vein which is the main draining vein for posterior cranial fossa, has a close relationship with trigeminal nerve. So the surgical approach or field was obstructed by the trunk or branches of the superior petrosal veins in microvascular decompression for trigeminal neuralgia. The treatment of the petrosal vein is a very important step in microvascular decompression for trigeminal neuralgia and also an important step to decrease the complication after operation.