{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T19:38:41Z","timestamp":1740166721569,"version":"3.37.3"},"reference-count":41,"publisher":"Georg Thieme Verlag KG","issue":"S 02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurol Surg B Skull Base"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003The superior petrosal vein (SPV) often obscures the surgical field or bleeds during microvascular decompression (MVD) for the treatment of trigeminal neuralgia. Although SPV sacrifice has been proposed, it is associated with multiple complications. We have performed more than 4,500 MVDs, including approximately 400 cases involving trigeminal neuralgia. We aimed to describe our operative technique and nuances to avoid SPV injury.<\/jats:p><jats:p>\n          Methods\u2003We have provided a detailed description of our institutional protocol, including the anesthesia technique, neurophysiologic monitoring, patient positioning, surgical approach, and SPV management. The surgical outcomes and treatment-related complications were retrospectively analyzed.<\/jats:p><jats:p>\n          Results\u2003No SPVs were sacrificed intentionally or accidentally during our MVD protocol for trigeminal neuralgia. In the 344 operations performed during 2006 to 2020, 269 (78.2%) patients did not require medication postoperatively, 58 (16.9%) tolerated the procedure with adequate medication, and 17 (4.9%) did not respond to MVD. Postoperatively, 35 (10.2%), 1 (0.3%), and 0 patients showed permanent trigeminal, facial, or vestibulocochlear nerve dysfunction, respectively. Wound infection occurred in five (1.5%) patients, while cerebrospinal fluid leaks occurred in three (0.9%) patients. Hemorrhagic complications appeared in four (1.2%) patients but these were unrelated to SPV injury. No surgery-related mortalities were reported.<\/jats:p><jats:p>\n          Conclusion\u2003MVD for the treatment of trigeminal neuralgia can be achieved safely without sacrificing the SPV. A key step is positioning the patient's vertex at a 10-degree elevation from the floor, which can ease venous return and loosen the SPV, making it less fragile to manipulation and providing a wider surgical corridor.<\/jats:p>","DOI":"10.1055\/s-0041-1725036","type":"journal-article","created":{"date-parts":[[2021,3,1]],"date-time":"2021-03-01T23:51:22Z","timestamp":1614642682000},"page":"e284-e290","source":"Crossref","is-referenced-by-count":0,"special_numbering":"S","title":["Prevention of Superior Petrosal Vein Injury during Microvascular Decompression for Trigeminal Neuralgia: Operative Nuances"],"prefix":"10.1055","volume":"83","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0128-4917","authenticated-orcid":false,"given":"Minsoo","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sang-Ku","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, The Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seunghoon","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, The Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeong-A","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, The Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kwan","family":"Park","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2021,3,1]]},"reference":[{"issue":"08","key":"ref1","doi-asserted-by":"crossref","first-page":"1464","DOI":"10.1016\/j.pain.2014.04.020","article-title":"Magnetic resonance imaging contribution for diagnosing symptomatic neurovascular contact in classical trigeminal neuralgia: a blinded case-control study and meta-analysis","volume":"155","author":"G Antonini","year":"2014","journal-title":"Pain"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1093\/brain\/awu349","article-title":"Significance of neurovascular contact in classical trigeminal neuralgia","volume":"138","author":"S Maarbjerg","year":"2015","journal-title":"Brain"},{"issue":"01","key":"ref3","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1080\/02688697.2016.1233321","article-title":"Clinical features and long-term surgical outcomes in 39 patients withtumor-related trigeminal neuralgia compared with 360 patients with idiopathic trigeminal neuralgia","volume":"31","author":"Y Wei","year":"2017","journal-title":"Br J Neurosurg"},{"issue":"10","key":"ref4","doi-asserted-by":"crossref","first-page":"776","DOI":"10.1212\/01.wnl.0000256340.16766.1d","article-title":"Loss of anisotropy in trigeminal neuralgia revealed by diffusion tensor imaging","volume":"68","author":"C Herweh","year":"2007","journal-title":"Neurology"},{"issue":"02","key":"ref5","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1148\/radiol.10100477","article-title":"Trigeminal neuralgia due to neurovascular compression: high-spatial-resolution diffusion-tensor imaging reveals microstructural neural changes","volume":"258","author":"J Lutz","year":"2011","journal-title":"Radiology"},{"issue":"15","key":"ref6","doi-asserted-by":"crossref","first-page":"1542","DOI":"10.1177\/0333102411424619","article-title":"Prevalence of trigeminal neuralgia and persistent idiopathic facial pain: a population-based study","volume":"31","author":"D Mueller","year":"2011","journal-title":"Cephalalgia"},{"issue":"01","key":"ref7","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1007\/s10194-006-0292-4","article-title":"The rare, unilateral headaches. V\u00e5g\u00e5 study of headache epidemiology","volume":"8","author":"O Sjaastad","year":"2007","journal-title":"J Headache Pain"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1016\/j.pain.2006.01.030","article-title":"Epidemiology and treatment of neuropathic pain: the UK primary care perspective","volume":"122","author":"G C Hall","year":"2006","journal-title":"Pain"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1016\/j.pain.2009.08.023","article-title":"Incidence of facial pain in the general population","volume":"147","author":"J S Koopman","year":"2009","journal-title":"Pain"},{"issue":"06","key":"ref10","doi-asserted-by":"crossref","first-page":"1166","DOI":"10.1097\/j.pain.0000000000000853","article-title":"Evaluating the impact of trigeminal neuralgia","volume":"158","author":"J M Zakrzewska","year":"2017","journal-title":"Pain"},{"issue":"06","key":"ref11","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1111\/ene.13950","article-title":"European Academy of Neurology guideline on trigeminal neuralgia","volume":"26","author":"L Bendtsen","year":"2019","journal-title":"Eur J Neurol"},{"issue":"06","key":"ref12","doi-asserted-by":"crossref","first-page":"1089","DOI":"10.1007\/s00701-012-1324-2","article-title":"Surgical technique for trigeminal microvascular decompression","volume":"154","author":"G Broggi","year":"2012","journal-title":"Acta Neurochir (Wien)"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1016\/j.wneu.2017.03.117","article-title":"Safety of superior petrosal vein sacrifice during microvascular decompression of the trigeminal nerve","volume":"103","author":"O N Pathmanaban","year":"2017","journal-title":"World Neurosurg"},{"issue":"03","key":"ref14","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1080\/02688690701397773","article-title":"Superior petrosal vein in trigeminal neuralgia","volume":"21","author":"K A Choudhari","year":"2007","journal-title":"Br J Neurosurg"},{"issue":"10","key":"ref15","doi-asserted-by":"crossref","first-page":"1342","DOI":"10.1016\/j.jocn.2008.12.024","article-title":"Cerebellar swelling after sacrifice of the superior petrosal vein during microvascular decompression for trigeminal neuralgia","volume":"16","author":"J Masuoka","year":"2009","journal-title":"J Clin Neurosci"},{"issue":"05","key":"ref16","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1136\/jnnp.69.5.679","article-title":"Contralateral hearing loss as an effect of venous congestion at the ipsilateral inferior colliculus after microvascular decompression: report of a case","volume":"69","author":"C Strauss","year":"2000","journal-title":"J Neurol Neurosurg Psychiatry"},{"issue":"08","key":"ref17","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1007\/s00701-007-1181-6","article-title":"Peduncular hallucinosis after sacrifice of veins of the petrosal venous complex for trigeminal neuralgia","volume":"149","author":"A Koerbel","year":"2007","journal-title":"Acta Neurochir (Wien)"},{"issue":"01","key":"ref18","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/0090-3019(93)90166-X","article-title":"Peduncular hallucinosis following microvascular decompression for trigeminal neuralgia: case report","volume":"40","author":"H Tsukamoto","year":"1993","journal-title":"Surg Neurol"},{"issue":"S 14","key":"ref19","doi-asserted-by":"crossref","first-page":"S415","DOI":"10.4103\/2152-7806.183520","article-title":"Sacrificing the superior petrosal vein during microvascular decompression. Is it safe? Learning the hard way. Case report and review of literature","volume":"7","author":"G Anichini","year":"2016","journal-title":"Surg Neurol Int"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"788","DOI":"10.1016\/j.wneu.2017.05.098","article-title":"Superior petrosal vein sacrifice during microvascular decompression: perioperative complication rates and comparison with venous preservation","volume":"104","author":"B D Liebelt","year":"2017","journal-title":"World Neurosurg"},{"issue":"03","key":"ref21","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1093\/ons\/opz163","article-title":"Absence of ischemic injury after sacrificing the superior petrosal vein during microvascular decompression","volume":"18","author":"Y Xia","year":"2020","journal-title":"Oper Neurosurg (Hagerstown)"},{"issue":"07","key":"ref22","doi-asserted-by":"crossref","first-page":"1490","DOI":"10.1016\/j.clinph.2018.03.006","article-title":"A new method for monitoring abnormal muscle response in hemifacial spasm: a prospective study","volume":"129","author":"S Lee","year":"2018","journal-title":"Clin Neurophysiol"},{"issue":"05","key":"ref23","doi-asserted-by":"crossref","first-page":"1097","DOI":"10.1016\/j.clinph.2017.12.032","article-title":"The critical warning sign of real-time brainstem auditory evoked potentials during microvascular decompression for hemifacial spasm","volume":"129","author":"S K Park","year":"2018","journal-title":"Clin Neurophysiol"},{"issue":"05","key":"ref24","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.3171\/2015.10.JNS151224","article-title":"Real-time intraoperative monitoring of brainstem auditory evoked potentials during microvascular decompression for hemifacial spasm","volume":"125","author":"B E Joo","year":"2016","journal-title":"J Neurosurg"},{"issue":"01","key":"ref25","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3171\/jns.1999.90.1.0001","article-title":"Microvascular decompression of cranial nerves: lessons learned after 4400 operations","volume":"90","author":"M R McLaughlin","year":"1999","journal-title":"J Neurosurg"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"S93","DOI":"10.1097\/00006123-200009001-00013","article-title":"The cerebellopontine angle and posterior fossa cranial nerves by the retrosigmoid approach","volume":"47","author":"A L Rhoton Jr","year":"2000","journal-title":"Neurosurgery"},{"key":"ref27","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1016\/j.jocn.2018.03.013","article-title":"A surgical strategy to prevent delayed epidural hematoma after posterior fossa surgery using lateral suboccipital retrosigmoid approach","volume":"52","author":"S Lee","year":"2018","journal-title":"J Clin Neurosci"},{"issue":"05","key":"ref28","doi-asserted-by":"crossref","first-page":"E5","DOI":"10.3171\/foc.2005.18.5.6","article-title":"Technique of microvascular decompression. Technical note","volume":"18","author":"P J Jannetta","year":"2005","journal-title":"Neurosurg Focus"},{"issue":"07","key":"ref29","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1016\/j.clineuro.2012.01.021","article-title":"A clinical analysis on microvascular decompression surgery in a series of 3000 cases","volume":"114","author":"J Zhong","year":"2012","journal-title":"Clin Neurol Neurosurg"},{"issue":"10","key":"ref30","doi-asserted-by":"crossref","first-page":"882","DOI":"10.1179\/1743132814Y.0000000344","article-title":"Microvascular decompression surgery: surgical principles and technical nuances based on 4000 cases","volume":"36","author":"J Zhong","year":"2014","journal-title":"Neurol Res"},{"issue":"01","key":"ref31","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1007\/s00701-019-04109-7","article-title":"Individual variations of the superior petrosal vein complex and their microsurgical relevance in 50 cases of trigeminal microvascular decompression","volume":"162","author":"M Basamh","year":"2020","journal-title":"Acta Neurochir (Wien)"},{"key":"ref32","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1016\/j.wneu.2018.06.160","article-title":"Veins of the cerebellopontine angle and specific complications of sacrifice, with special emphasis on microvascular decompression surgery. A review","volume":"117","author":"C Dumot","year":"2018","journal-title":"World Neurosurg"},{"issue":"12","key":"ref33","doi-asserted-by":"crossref","first-page":"1090","DOI":"10.1080\/01616412.2015.1115588","article-title":"Management of different kinds of veins during microvascular decompression for trigeminal neuralgia: technique notes","volume":"37","author":"B Feng","year":"2015","journal-title":"Neurol Res"},{"issue":"S 05","key":"ref34","doi-asserted-by":"crossref","first-page":"S428","DOI":"10.1055\/s-0038-1669968","article-title":"Microsurgical decompression of trigeminal neuralgia caused by simultaneous double arterial (SCA and AICA) and petrosal vein complex compression","volume":"79","author":"D Gajski","year":"2018","journal-title":"J Neurol Surg B Skull Base"},{"issue":"05","key":"ref35","doi-asserted-by":"crossref","first-page":"1037","DOI":"10.1007\/s00701-011-0957-x","article-title":"Clinical features and surgical treatment of trigeminal neuralgia caused solely by venous compression","volume":"153","author":"W Hong","year":"2011","journal-title":"Acta Neurochir (Wien)"},{"issue":"04","key":"ref36","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1007\/s00701-017-3085-4","article-title":"Diagnosis and management for trigeminal neuralgia caused solely by venous compression","volume":"159","author":"T Inoue","year":"2017","journal-title":"Acta Neurochir (Wien)"},{"issue":"12","key":"ref37","doi-asserted-by":"crossref","first-page":"2125","DOI":"10.1007\/s00701-010-0840-1","article-title":"Surgical treatment of trigeminal neuralgia. Results from the use of glycerol injection, microvascular decompression, and rhizotomia","volume":"152","author":"J Degn","year":"2010","journal-title":"Acta Neurochir (Wien)"},{"issue":"05","key":"ref38","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.3171\/2014.12.JNS14469","article-title":"Long-term efficacy and safety of internal neurolysis for trigeminal neuralgia without neurovascular compression","volume":"122","author":"A L Ko","year":"2015","journal-title":"J Neurosurg"},{"issue":"06","key":"ref39","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1055\/s-2006-960487","article-title":"Microvascular decompression for trigeminal neuralgia: a long-term follow-up study","volume":"49","author":"M N Pamir","year":"2006","journal-title":"Minim Invasive Neurosurg"},{"issue":"06","key":"ref40","doi-asserted-by":"crossref","first-page":"1255","DOI":"10.1227\/NEU.0b013e31822ba315","article-title":"Posterior fossa exploration for trigeminal neuralgia patients older than 70 years of age","volume":"69","author":"B E Pollock","year":"2011","journal-title":"Neurosurgery"},{"issue":"03","key":"ref41","doi-asserted-by":"crossref","first-page":"527","DOI":"10.3171\/jns.2002.96.3.0527","article-title":"Predictors of outcome in surgically managed patients with typical and atypical trigeminal neuralgia: comparison of results following microvascular decompression","volume":"96","author":"E C Tyler-Kabara","year":"2002","journal-title":"J Neurosurg"}],"container-title":["Journal of Neurological Surgery Part B: Skull Base"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0041-1725036.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,7]],"date-time":"2024-06-07T07:45:26Z","timestamp":1717746326000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0041-1725036"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,1]]},"references-count":41,"journal-issue":{"issue":"S 02","published-online":{"date-parts":[[2022,7,10]]},"published-print":{"date-parts":[[2022,6]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0041-1725036","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2193-6331","2193-634X"],"issn-type":[{"type":"print","value":"2193-6331"},{"type":"electronic","value":"2193-634X"}],"subject":[],"published":{"date-parts":[[2021,3,1]]}}}