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Acta Neurochirurgica
Published in: Acta Neurochirurgica 9/2013

01-09-2013 | Clinical Article - Vascular

Microvascular decompression for neurovascular conflicts in the cerebello-pontine angle: which role for endoscopy?

Authors: Morgan Broggi, Francesco Acerbi, Paolo Ferroli, Giovanni Tringali, Marco Schiariti, Giovanni Broggi

Published in: Acta Neurochirurgica | Issue 9/2013

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Abstract

Background

Microvascular decompression (MVD) is the surgical intervention designed to resolve neurovascular conflicts (NCs) in the cerebellopontine angle (CPA). Today, endoscopy is commonly used in many neurosurgical procedures. This study aims to retrospectively assess the usefulness of endoscopy during MVD, focusing on microscopic endoscopic-assisted (MEA) MVD.

Methods

Between January 2010 and December 2012, 141 patients underwent MVD procedures: 119 (84.5 %) were affected by idiopathic trigeminal neuralgia (TN), 20 (14 %) by hemifacial spasm (HFS), 1 by glossopharyngeal neuralgia (GN) and 1 by TN and GN simultaneously; 128 (91 %) MVD were first time procedures, while 13 (9 %) were recurrences (10 TN, 3 HFS). Visualization techniques used were: pure microscopic in 89 (63 %) cases, fully endoscopic in 12 (8.5 %) and MEA in 40 (28.5 %). The MEA technique was used when the conflict was not clearly identified under microscopic view or it was not certainly resolved.

Results

Overall, a NC was found in 130 (92 %) cases, while 11 patients had no intraoperative evidence of NC. Considering specifically the 40 MEA cases, 12 (8.5 % overall) conflicts not clearly visible with the microscope were revealed and solved, a complete conflict resolution was confirmed in 13 (9 % overall) cases, while an incomplete conflict resolution was shown in four cases (3 % overall).

Conclusion

Pure microscopic MVD remains the technique of choice. The endoscope is a useful adjunctive imaging tool in confirming NCs identified by the microscope, revealing conflicts missed by the microscopic survey alone and verifying adequate nerve decompression.
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Metadata
Title
Microvascular decompression for neurovascular conflicts in the cerebello-pontine angle: which role for endoscopy?
Authors
Morgan Broggi
Francesco Acerbi
Paolo Ferroli
Giovanni Tringali
Marco Schiariti
Giovanni Broggi
Publication date
01-09-2013
Publisher
Springer Vienna
Published in
Acta Neurochirurgica / Issue 9/2013
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI
https://doi.org/10.1007/s00701-013-1824-8

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