{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T15:13:09Z","timestamp":1780067589222,"version":"3.54.0"},"reference-count":20,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n<jats:title>Background<\/jats:title>\n<jats:p>Microvascular decompression (MVD) using a microscope is commonly performed for trigeminal neuralgia (TN). The advantages of endoscopic surgery for MVD are not clear. We report a case of TN caused by a Meckel\u2019s cave meningioma extending to the posterior fossa, which was successfully treated through surgical resection using a combination of a microscope and endoscope.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st2\">\n<jats:title>Case Description<\/jats:title>\n<jats:p>A 63-year-old patient complained of left facial pain. Magnetic resonance imaging showed a 30 \u00d7 30 \u00d7 25 mm mass lesion in the left petroclival region that had extended into Meckel\u2019s cave. Three-dimensional computed tomography angiography demonstrated that the trigeminal nerve passed between the tumor and the tortuous vertebral artery (VA). We selected the anterior transpetrosal approach. The trigeminal nerve was displaced due to compression by the tumor, so the entire course of the trigeminal nerve was difficult to visualize even after tumor removal. Consequently, we switched from the microscope to an endoscope and observed the root entry zone (REZ) of the trigeminal nerve. We confirmed that the VA compressed the REZ of the trigeminal nerve and inserted small Teflon pieces to relieve the compression. TN disappeared, and he was discharged home with no complications.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st3\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Surgical resection of tumors near the trigeminal nerve causing TN must carefully examine the trigeminal nerve from the REZ to Meckel\u2019s cave to identify any coexistent vascular compression, which may be difficult using only a microscope due to significant displacement of the trigeminal nerve. In such cases, the use of an endoscope is effective to inspect the entire trigeminal nerve directly.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_1053_2024","type":"journal-article","created":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T08:35:17Z","timestamp":1743755717000},"page":"123","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Trigeminal neuralgia caused by compression of the trigeminal nerve between the vertebral artery and Meckel\u2019s cave meningioma extending to the posterior fossa successfully treated with the endoscopic-assisted anterior petrosal approach"],"prefix":"10.25259","volume":"16","author":[{"given":"Moeto","family":"Moteki","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Fukaya Red Cross Hospital, Fukaya, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masanori","family":"Aihara","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Gunma University Graduate School of Medicine, Maebashi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soichi","family":"Oya","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Gunma University Graduate School of Medicine, Maebashi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2025,4,4]]},"reference":[{"key":"10.25259\/SNI_1053_2024\/ref-1","doi-asserted-by":"crossref","first-page":"818","DOI":"10.3171\/jns.1996.84.5.0818","article-title":"Long-term outcome after operation for trigeminal neuralgia in patients with posterior fossa tumors","volume":"84","author":"Barker","year":"1996","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI_1053_2024\/ref-2","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1055\/s-2002-33457","article-title":"Comparison of the exposure obtained by endoscope and microscope in the extended trans-sphenoidal approach","volume":"12","author":"Batay","year":"2002","journal-title":"Skull Base"},{"key":"10.25259\/SNI_1053_2024\/ref-3","first-page":"ons44","article-title":"Quantitative comparison of Kawase\u2019s approach versus the retrosigmoid approach: Implications for tumors involving both middle and posterior fossae","volume":"64","author":"Chang","year":"2009","journal-title":"Neurosurgery"},{"key":"10.25259\/SNI_1053_2024\/ref-4","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/j.wneu.2023.06.013","article-title":"Multiscope technique combining an endoscope and exoscope for neck clipping of cerebral aneurysms","volume":"177","author":"Cho","year":"2023","journal-title":"World Neurosurg"},{"key":"10.25259\/SNI_1053_2024\/ref-5","doi-asserted-by":"crossref","first-page":"1639","DOI":"10.1007\/s00701-021-04798-z","article-title":"Petroclival meningiomas: Update of current treatment and consensus by the EANS skull base section","volume":"163","author":"Giammattei","year":"2021","journal-title":"Acta Neurochir (Wien)"},{"key":"10.25259\/SNI_1053_2024\/ref-6","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1016\/j.wneu.2021.04.133","article-title":"Petroclival meningioma leading to trigeminal neuralgia: A Kawase approach application","volume":"151","author":"Gomes da Silva","year":"2021","journal-title":"World Neurosurg"},{"key":"10.25259\/SNI_1053_2024\/ref-7","first-page":"1330","article-title":"Endoscopic neurosurgery and endoscope-assisted microneurosurgery for the treatment of intracranial cysts","volume":"43","author":"Hopf","year":"1998","journal-title":"Neurosurgery"},{"key":"10.25259\/SNI_1053_2024\/ref-8","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1007\/s00701-024-06298-2","article-title":"Exo-and endoscopic two-step approach for meningeal tumours invading the lateral wall of large dural venous sinuses: How I do it","volume":"166","author":"Iwami","year":"2024","journal-title":"Acta Neurochir (Wien)"},{"key":"10.25259\/SNI_1053_2024\/ref-9","doi-asserted-by":"crossref","first-page":"929","DOI":"10.1016\/j.wneu.2015.02.003","article-title":"Which routes for petroclival tumors? 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