Meckel’s cave compression with Teflon for the treatment of idiopathic trigeminal neuralgia: its possibility as a modified surgical technique

Objective: We analyzed the clinical outcomes of Meckel’s cave compression with Teflon (Rhee’s method) as a new modified and additional surgical technique for trigeminal neuralgia (TN).Methods: Between March 1996 and December 2014, out of 78 patients who were treated with microvascular decompression (MVD) or partial sensory root rhizotomy, 28 patients additionally underwent Meckel’s cave compression with Teflon. The mean age at initial treatment was 54.3 years (range: 40–69 years). The mean duration from onset to operation was 70.5 months (range: 5–360 months) and the mean follow-up period was 26 months (range: 1–77 months). Results: Fifteen patients (53.6%) had facial pain in the V2/V3 distribution. The offending or associating vessel was the superior cerebellar artery in four patients (14.3%), the superior petrosal vein in six (21.4%), the anterior inferior cerebellar artery in two (7.1%), multiple vessels in nine (32.1%), and miscellaneous arteries or veins in six (21.4%). One patient (3.6%) had no offending vessel, and seven patients were had no definite offending vessels that contacted the trigeminal root entry zone. Meckel’s cave compression with Teflon was applied to all patients: 10 (35.7%) in combination with MVD, one (3.6%) with partial rhizotomy, and 17 (60.7%) with both MVD and partial rhizotomy. TN was relieved in 26 patients (92.9%) and symptoms recurred in three patients (pain-free rate: 82.1%). The complication rate of this method appeared to be similar to other treatment procedures. Conclusion: Meckel’s cave compression with Teflon may be a safe and useful additional treatment procedure for TN.