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DOI: 10.1055/s-0031-1273731
© Georg Thieme Verlag KG Stuttgart · New York
Microvascular Decompression for Trigeminal Neuralgia: Visualization of Results in a 3D Stereoscopic Virtual Reality Environment
Publikationsverlauf
Publikationsdatum:
19. April 2011 (online)

Abstract
Background: This study employs 3D stereoscopic virtual reality technology to demonstrate the surgical results of microvascular decompression (MVD) for trigeminal neuralgia.
Patients/Material and Methods: 3D models were rendered by fusing CTA and MRI fast imaging employing steady state acquisition (FIESTA) modalities of both pre- and post-operative scans. The brainstem, trigeminal nerve root and relevant vasculature were extracted, superimposed, and co-registered to bony and ventricular anatomy.
Results: 3 clinically successful MVD cases were evaluated for superior cerebellar artery (SCA) vessel displacement. Qualitative parameters included translational and rotational shift of the SCA, and distance decompressed from the trigeminal nerve root entry zone. Parameters were met in each case, with demonstration of vessel displacement and decompression of the nerve root.
Conclusion: The 3D virtual-reality environment with stereoscopic visualization offers a method through which to visualize the results of MVD, and a potential reference point to evaluate cases of treatment failure or relapse.
Key words
trigeminal neuralgia - microvascular decompression - CTA - MRI FIESTA - 3D stereoscopic model
References
- 1
Love S, Coakham H.
Trigeminal neuralgia pathology and pathogenesis.
Brain.
2001;
2347-2360
MissingFormLabel
- 2
Ashkan K, Marsh H.
Microvascular decompression for trigeminal neuralgia in the elderly: A review of the
safety and efficacy.
Neurosurgery.
2004;
55
840-850
MissingFormLabel
- 3
Barker F, Jannetta P, Bissonette D. et al .
The long-term outcome of microvascular decompression for trigeminal neuralgia.
New Engl J Med.
1996;
334
1077-1083
MissingFormLabel
- 4
Devor M, Govrin-Lippman R, Rappaport H.
Mechanism of trigeminal neuralgia: an ultrastructural analysis of trigeminal root
specimens obtained during microvascular decompression surgery.
J Neurosurg.
2002;
96
532-543
MissingFormLabel
- 5
Kalkanis S, Eskandar E, Carter B. et al .
Microvascular decompression surgery in the United States, 1996–2000: Mortality rates
and morbidity rates, and the effects of hospital and surgeon volumes.
Neurosurgery.
2003;
52
1251-1262
MissingFormLabel
- 6
Kabatas S, Karasu A, Civelek E. et al .
Microvascular decompression as a surgical management for trigeminal neuralgia: long-term
follow-up and review of the literature.
Neurosurg Rev.
2009;
32
87-94
MissingFormLabel
- 7
Jannetta P.
Arterial compression of the trigeminal nerve at the pons in patients with trigeminal
neuralgia.
J Neurosurg.
1967;
26
159-162
MissingFormLabel
- 8
Tatli M, Satici O, Kanpolat Y. et al .
Various surgical modalities for trigeminal neuralgia: literature study of respective
long-term outcomes.
Acta Neurochirurg.
2008;
150
243-255
MissingFormLabel
- 9
Sindou M, Leston J, Decullier E. et al .
Microvascular decompression for primary trigeminal neuralgia: long-term effectiveness
and prognostic factors in a series of 362 consecutive patients with clear-cut neurovascular
conflicts who underwent pure decompression.
J Neurosurg.
2007;
107
1144-1153
MissingFormLabel
- 10
Cho D-Y, Chang CG-S, Wang Y-c. et al .
Repeat operations in failed microvascular decompression for trigeminal neuralgia.
Neurosurgery.
1994;
35
665-670
MissingFormLabel
- 11
Kureshi S, Wilkins R.
Posterior fossa re-exploration for persistent or recurrent trigeminal neuralgia or
hemifacial spasm: Surgical findings and therapeutic implications.
Neurosurgery.
1998;
43
1111-1117
MissingFormLabel
- 12
Klun B, Prestor B.
Microvascular relations of the trigeminal nerve: an anatomical study.
Neurosurgery.
1986;
19
535-539
MissingFormLabel
- 13
Hardy D, Rhoton A.
Microsurgical relationships of the superior cerebellar artery and the trigeminal nerve.
J Neurosurg.
1978;
49
669-678
MissingFormLabel
- 14
Haines S, Jannetta P, Zorub D.
Microvascular relations of the trigeminal nerve: an anatomical study with clinical
correlation.
J Neurosurg.
1980;
52
381-386
MissingFormLabel
- 15
Tash R, Sze G, Leslie D.
Trigeminal neuralgia: MR imaging features.
Radiology.
1989;
172
767-770
MissingFormLabel
- 16
Anderson V, Berryhill P, Sandquist M. et al .
High-resolution three-dimensional magnetic resonance angiography and three-dimensional
spoiled gradient-recalled imaging in the evaluation of neurovascular compression in
patients with trigeminal neuralgia: a double blind pilot study.
Neurosurgery.
2006;
58
666-673
MissingFormLabel
- 17
Miller J, Acar F, Hamilton BB. et al .
Preoperative visualization of neurovascular anatomy in trigeminal neuralgia.
J Neurosurg.
2008;
108
477-482
MissingFormLabel
- 18
Takao T, Oishi M, Ishida G. et al .
Three-dimensional visualization of neurovascular compression: presurgical use of virtual
endoscopy created form magnetic resonance imaging.
Neurosurgery.
2008;
63
ONS 141-ONS 148
MissingFormLabel
Correspondence
C. D. GandhiMD
UMDNJ-New Jersey
Medical School
Department of Neurological
Surgery
90 Bergen St., Suite 8100
Newark, NJ 07101
Telefon: +1/973/972 9626
Fax: +1/973/972 2333
eMail: gandhich@umdnj.edu