A concise operative atlas of microvascular decompression – Different intraoperative scenarios and technical nuances

Abstract

Background: Trigeminal neuralgia is one of the most common facial pain syndromes. Although there are many postulated hypotheses explaining the pain, microvascular compression of the root entry zone (REZ) of the trigeminal nerve is commonly accepted to be the pathology for neuralgia. Various medical and surgical treatments are available to relieve the pain and microvascular decompression of the trigeminal nerve at the REZ is considered as the most successful modality and the gold standard. Methods: In this video atlas on operative nuances, we have described nine common scenarios that could be encountered during this surgery. Conclusion: Thorough knowledge of the different intraoperative scenarios is crucial for a complete microvascular decompression that translates into a good post-operative outcome.