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Skull Base NeurosurgerySeries 1 | Series 2 | Series 3 |
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Series 1. Trigeminal Neuralgia |
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A classical skull base approach is used to access the area that may be abnormal in the condition known as TIC DOLOREAUX or TRIGEMINAL NEURALGIA. This is a condition that causes excruciating pain in different areas of the face and is most commonly a result of an abnormal blood vessel beating against the trigeminal nerve as it enters the brainstem. Mostly due to the brilliant work of Peter Janetta, an American neurosurgeon, we know that the condition can be potentially cured once the vessel is identified and separated from the nerve. With the use of endoscopy, more abnormal vessels are identified than with standard microscopic techniques and as a result, we may find that results will be better in terms of short and long term cures. This operation can be performed through very small openings and has been referred to as "keyhole surgery". |
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| An example of the very limited opening needed to gain access to the trigeminal nerve. |  |
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| This photo nicely demonstrates the excellent and superior view one gets using the endoscope in the confined spaces of the posterior fossa. In this case, the abnormal vessel is seen against the trigeminal nerve. This patient, along with 85 of the last 86 patients operated at the CMIN, awoke pain free and has remained pain free ever since with an average follow-up of 3 years. Unfortunately, failures can still occur after 10 years but most failures will declare themselves in the first 3 years. |  |
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| The closure must be meticulous to avoid one of the more common complications of any skull base approach; spinal fluid leakage. |  |
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| Last updated on Thursday 13th October, 2005. |