{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T18:47:53Z","timestamp":1792176473735,"version":"4.4.0"},"reference-count":16,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,4]]},"abstract":"\n OBJECTIVE<\/jats:title>\n Trigeminal neuralgia is a debilitating pain disorder most often caused by arterial compression of the trigeminal nerve, although there are other etiologies. Microvascular decompression (MVD) remains the most definitive treatment for this disorder, with cure rates reported between 60% and 80%. Traditional MVD techniques involve a retrosigmoid craniotomy with placement of an inert foreign material, such as Teflon, between the nerve and compressive vessel. Recurrence of trigeminal neuralgia after MVD has been associated with vessel migration, adhesion formation, and arterial pulsation against the Teflon abutting the nerve. Additionally, foreign materials such as Teflon have been reported to trigger inflammatory responses, resulting in recurrence of trigeminal pain. An alternative method for decompression involves the use of a sling to transpose the compressive vessel away from the nerve. Results of various sling techniques as a decompressive strategy are limited to small series and case reports. In this study, the authors present their experience utilizing a tentorial sling for MVD in patients with trigeminal neuralgia.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n Institutional review board approval was obtained in order to contact patients who underwent MVD for trigeminal neuralgia via the tentorial sling technique. Clinical outcomes were assessed utilizing the Barrow Neurological Institute (BNI) pain intensity score immediately after surgery and at the time of the study.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n The tentorial sling technique was performed in 45 patients undergoing MVD for trigeminal neuralgia. In 41 of these patients, this procedure was their first decompressive surgery. Immediate postoperative relief of pain (BNI score I) was achieved in 80% of patients undergoing their first decompressive procedure. At last follow-up, 73% of these patients remained pain free. Three patients experienced recurrent trigeminal pain, with surgical exploration demonstrating an intact tentorial sling. The complication rate was 6.6%.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n Transposition techniques for MVD have been described previously in small series and case reports. This study represents the largest experience in which the utilization of a tentorial sling for MVD in patients with trigeminal neuralgia is described. The technique represents a novel method for decompression of the trigeminal nerve by transposition of the offending vessel without the use of foreign material. Although the authors\u2019 preliminary results parallel the historical cure rate, further outcome data are required to assess long-term durability of this method.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2017.10.jns17971","type":"journal-article","created":{"date-parts":[[2018,4,20]],"date-time":"2018-04-20T09:59:58Z","timestamp":1524218398000},"page":"1315-1320","source":"Crossref","is-referenced-by-count":35,"title":["Tentorial sling for microvascular decompression in patients with trigeminal neuralgia: a description of operative technique and clinical outcomes"],"prefix":"10.3171","volume":"130","author":[{"given":"Jeffrey A.","family":"Steinberg","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University of California, San Diego, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jayson","family":"Sack","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of California, San Diego, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bayard","family":"Wilson","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of California, San Diego, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Weingarten","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of California, San Diego, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bob","family":"Carter","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of California, San Diego, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Khalessi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of California, San Diego, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharona","family":"Ben-Haim","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of California, San Diego, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Alksne","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of California, San Diego, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"N Engl J Med","doi-asserted-by":"publisher","first-page":"1077","DOI":"10.1056\/NEJM199604253341701","article-title":"The long-term outcome of microvascular decompression for trigeminal neuralgia","volume":"334","author":"Barker FG II","year":"1996","unstructured":"Barker FG II, Jannetta PJ, Bissonette DJ, Larkins MV, Jho HD: The long-term outcome of microvascular decompression for trigeminal neuralgia. N Engl J Med 334:1077\u20131083, 1996859886510.1056\/NEJM199604253341701"},{"key":"b2","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"145","DOI":"10.3171\/jns.1999.90.1.0145","article-title":"Aseptic meningitis caused by Teflon implantation for microvascular decompression. Case report","volume":"90","author":"Bobek MP","year":"1999","unstructured":"Bobek MP, Sagher O: Aseptic meningitis caused by Teflon implantation for microvascular decompression. Case report. J Neurosurg 90:145\u2013147, 19991041316910.3171\/jns.1999.90.1.0145"},{"key":"b3","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"35","DOI":"10.3171\/jns.1988.69.1.0035","article-title":"Long-term efficacy of microvascular decompression in trigeminal neuralgia","volume":"69","author":"Burchiel KJ","year":"1988","unstructured":"Burchiel KJ, Clarke H, Haglund M, Loeser JD: Long-term efficacy of microvascular decompression in trigeminal neuralgia. J Neurosurg 69:35\u201338, 1988245430310.3171\/jns.1988.69.1.0035"},{"key":"b4","series-title":"J Headache Pain","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1007\/s10194-010-0213-4","article-title":"Treatment of recurrent trigeminal neuralgia due to Teflon granuloma","volume":"11","author":"Capelle HH","year":"2010","unstructured":"Capelle HH, Brandis A, Tschan CA, Krauss JK: Treatment of recurrent trigeminal neuralgia due to Teflon granuloma. J Headache Pain 11:339\u2013344, 20102041932910.1007\/s10194-010-0213-4"},{"key":"b5","series-title":"Surg Neurol","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1016\/S0090-3019(00)00169-5","article-title":"Teflon granuloma after microvascular decompression for trigeminal neuralgia","volume":"53","author":"Chen J","year":"2000","unstructured":"Chen J, Lee S, Lui T, Yeh Y, Chen T, Tzaan W: Teflon granuloma after microvascular decompression for trigeminal neuralgia. Surg Neurol 53:281\u2013287, 20001077326210.1016\/S0090-3019(00)00169-5"},{"key":"b6","series-title":"Eur J Neurol","doi-asserted-by":"publisher","first-page":"1013","DOI":"10.1111\/j.1468-1331.2008.02185.x","article-title":"AAN-EFNS guidelines on trigeminal neuralgia management","volume":"15","author":"Cruccu G","year":"2008","unstructured":"Cruccu G, Gronseth G, Alksne J, Argoff C, Brainin M, Burchiel K, : AAN-EFNS guidelines on trigeminal neuralgia management. Eur J Neurol 15:1013\u20131028, 20081872114310.1111\/j.1468-1331.2008.02185.x"},{"key":"b7","series-title":"No Shinkei Geka","first-page":"1257","article-title":"[Posterior cranial fossa neurovascular decompression (Jannetta method) for trigeminal neuralgia and facial spasm.]","volume":"10","author":"Fukushima T","year":"1982","unstructured":"Fukushima T: [Posterior cranial fossa neurovascular decompression (Jannetta method) for trigeminal neuralgia and facial spasm.] No Shinkei Geka 10:1257\u20131261, 1982 (Jpn)7170067"},{"key":"b8","series-title":"Neurosurg Rev","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1007\/s10143-015-0607-5","article-title":"Outcome of microvascular decompression for trigeminal neuralgia treated with the stitched sling retraction technique","volume":"38","author":"Masuoka J","year":"2015","unstructured":"Masuoka J, Matsushima T, Inoue K, Nakahara Y, Takase Y, Kawashima M: Outcome of microvascular decompression for trigeminal neuralgia treated with the stitched sling retraction technique. Neurosurg Rev 38:361\u2013365, 20152566330810.1007\/s10143-015-0607-5"},{"key":"b9","series-title":"Neurosurg Rev","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1007\/s10143-011-0310-0","article-title":"Stitched sling retraction technique for microvascular decompression: procedures and techniques based on an anatomical viewpoint","volume":"34","author":"Masuoka J","year":"2011","unstructured":"Masuoka J, Matsushima T, Kawashima M, Nakahara Y, Funaki T, Mineta T: Stitched sling retraction technique for microvascular decompression: procedures and techniques based on an anatomical viewpoint. Neurosurg Rev 34:373\u2013380, 201110.1007\/s10143-011-0310-0"},{"key":"b10","series-title":"Acta Neurochir (Wien)","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1007\/s007010050469","article-title":"Recurrent trigeminal neuralgia after microvascular decompression using an interposing technique. Teflon felt adhesion and the sling retraction technique","volume":"142","author":"Matsushima T","year":"2000","unstructured":"Matsushima T, Yamaguchi T, Inoue TK, Matsukado K, Fukui M: Recurrent trigeminal neuralgia after microvascular decompression using an interposing technique. Teflon felt adhesion and the sling retraction technique. Acta Neurochir (Wien) 142:557\u2013561, 200010.1007\/s007010050469"},{"key":"b11","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"127","DOI":"10.3171\/jns.1996.84.1.0127","article-title":"A tentorial sling in microvascular decompression for trigeminal neuralgia. Technical note","volume":"84","author":"Melvill RL","year":"1996","unstructured":"Melvill RL, Baxter BL: A tentorial sling in microvascular decompression for trigeminal neuralgia. Technical note. J Neurosurg 84:127\u2013128, 1996861382010.3171\/jns.1996.84.1.0127"},{"key":"b12","series-title":"Acta Neurochir (Wien)","doi-asserted-by":"publisher","first-page":"1181","DOI":"10.1007\/s00701-014-2092-y","article-title":"Microvascular decompression for trigeminal neuralgia using the \u2018stitched sling retraction\u2019 technique in recurrent cases after previous microvascular decompression","volume":"156","author":"Meybodi AT","year":"2014","unstructured":"Meybodi AT, Habibi Z, Miri M, Tabatabaie SAF: Microvascular decompression for trigeminal neuralgia using the \u2018stitched sling retraction\u2019 technique in recurrent cases after previous microvascular decompression. Acta Neurochir (Wien) 156:1181\u20131187, 201410.1007\/s00701-014-2092-y"},{"key":"b13","series-title":"Neurosurg Rev","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1007\/s10143-008-0144-6","article-title":"The \u201changing technique\u201d of vascular transposition in microvascular decompression for trigeminal neuralgia: technical report of four cases","volume":"31","author":"Mitsos AP","year":"2008","unstructured":"Mitsos AP, Georgakoulias N, Lafazanos SA, Konstantinou EA: The \u201changing technique\u201d of vascular transposition in microvascular decompression for trigeminal neuralgia: technical report of four cases. Neurosurg Rev 31:327\u2013330, 20081847054510.1007\/s10143-008-0144-6"},{"key":"b14","series-title":"Int J Radiat Oncol Biol Phys","doi-asserted-by":"publisher","first-page":"1013","DOI":"10.1016\/S0360-3016(00)00513-7","article-title":"Gamma knife radiosurgery for trigeminal neuralgia: the initial experience of the Barrow Neurological Institute","volume":"47","author":"Rogers CL","year":"2000","unstructured":"Rogers CL, Shetter AG, Fiedler JA, Smith KA, Han PP, Speiser BL: Gamma knife radiosurgery for trigeminal neuralgia: the initial experience of the Barrow Neurological Institute. Int J Radiat Oncol Biol Phys 47:1013\u20131019, 20001086307310.1016\/S0360-3016(00)00513-7"},{"key":"b15","series-title":"J Craniofac Surg","doi-asserted-by":"publisher","first-page":"491","DOI":"10.1097\/SCS.0000000000001523","article-title":"Second microvascular decompression for trigeminal neuralgia in recurrent cases after microvascular decompression","volume":"26","author":"Yang DB","year":"2015","unstructured":"Yang DB, Jiang DY, Chen HC, Wang ZM: Second microvascular decompression for trigeminal neuralgia in recurrent cases after microvascular decompression. J Craniofac Surg 26:491\u2013494, 20152575992110.1097\/SCS.0000000000001523"},{"key":"b16","series-title":"BMJ","doi-asserted-by":"publisher","first-page":"g474","DOI":"10.1136\/bmj.g474","article-title":"Trigeminal neuralgia","volume":"348","author":"Zakrzewska JM","year":"2014","unstructured":"Zakrzewska JM, Linskey ME: Trigeminal neuralgia. BMJ 348:g474, 20142453411510.1136\/bmj.g474"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/130\/4\/article-p1315.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/130\/4\/article-p1315.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/130\/4\/article-p1315.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,26]],"date-time":"2023-03-26T03:03:34Z","timestamp":1679799814000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/130\/4\/article-p1315.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,4]]},"references-count":16,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.3171\/2017.10.jns17971","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,4]]}}}