{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T00:57:04Z","timestamp":1773449824641,"version":"3.50.1"},"reference-count":28,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,8]]},"abstract":"<jats:sec><jats:title>OBJECTIVE<\/jats:title><jats:p>Surgical exposure and decompression of the entire trigeminal nerve in a conventional lateral supracerebellar approach can be challenging because of blockages from the superior petrosal vein complex, cerebellum, and vestibulocochlear nerve. The authors demonstrate a novel suprafloccular approach via the petrosal fissure and venous corridors that can be used as a substitute for the conventional route used to treat trigeminal neuralgia and present a consecutive series of patients and their clinical outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Preoperative and postoperative clinical data from 420 patients who underwent this modified approach at Hangzhou First People\u2019s Hospital between March 2012 and May 2014 were reviewed. The technique expands the working space by opening the petrosal fissure and dissecting adhesions between the vein of the cerebellopontine fissure and the simple lobule as needed. Via 3 surgical corridors, the entire trigeminal nerve is exposed and decompressed thoroughly with minimal retraction of the surrounding vital structures.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>The medial one-third of the trigeminal nerve accounted for the majority (275 [65.5%] cases) of neurovascular conflict sites. The lateral corridor was used in 219 (52.1%) cases, the medial corridor was used in 175 (41.7%) cases, and the intermediate corridor was used in 26 (6.2%) cases. The entire trigeminal nerve in each patient was accessed directly and decompressed properly. At the end of the 24-month follow-up period, the rate of excellent results (Kondo score of T0 or T1) was stable at approximately 90.5%. No complications were related directly to petrosal vein or vestibulocochlear nerve injury.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Based on data from the large patient series, the authors found this suprafloccular approach via the petrosal fissure and venous corridors provides full exposure and decompression of the entire trigeminal nerve, a high cure rate, and a low neurovascular morbidity rate.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2017.5.jns17515","type":"journal-article","created":{"date-parts":[[2017,10,20]],"date-time":"2017-10-20T13:59:51Z","timestamp":1508507991000},"page":"324-333","source":"Crossref","is-referenced-by-count":4,"title":["Suprafloccular approach via the petrosal fissure and venous corridors for microvascular decompression of the trigeminal nerve: technique notes and clinical outcomes"],"prefix":"10.3171","volume":"129","author":[{"given":"Hao","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Hangzhou First People\u2019s Hospital, Nanjing Medical University; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiang","family":"Ying","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hangzhou First People\u2019s Hospital, Nanjing Medical University; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wen H.","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hangzhou First People\u2019s Hospital, Nanjing Medical University; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiang","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hangzhou First People\u2019s Hospital, Nanjing Medical University; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiao Q.","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hangzhou First People\u2019s Hospital, Nanjing Medical University; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yong F.","family":"Sheng","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hangzhou Cancer Hospital, Hangzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ding","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hangzhou First People\u2019s Hospital, Nanjing Medical University; and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"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":"World Neurosurg","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1016\/j.wneu.2010.05.001","article-title":"Operative strategies for minimizing hearing loss and other major complications associated with microvascular decompression for trigeminal neuralgia","volume":"74","author":"Bond AE","year":"2010","unstructured":"Bond AE, Zada G, Gonzalez AA, Hansen C, Giannotta SL: Operative strategies for minimizing hearing loss and other major complications associated with microvascular decompression for trigeminal neuralgia. World Neurosurg 74:172\u2013177, 20102130001010.1016\/j.wneu.2010.05.001"},{"key":"b3","series-title":"Acta Neurochir (Wien)","doi-asserted-by":"publisher","first-page":"1089","DOI":"10.1007\/s00701-012-1324-2","article-title":"Surgical technique for trigeminal microvascular decompression","volume":"154","author":"Broggi G","year":"2012","unstructured":"Broggi G, Broggi M, Ferroli P, Franzini A: Surgical technique for trigeminal microvascular decompression. Acta Neurochir (Wien) 154:1089\u20131095, 201210.1007\/s00701-012-1324-222531963"},{"issue":"1 Suppl Operative","key":"b4","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"ons99","DOI":"10.1097\/00006123-200009001-00013","article-title":"Dural landmark to locate the internal auditory canal in large and giant vestibular schwannomas: the T\u00fcbingen line","volume":"69","author":"Campero A","year":"2011","unstructured":"Campero A, Martins C, Rhoton A Jr, Tatagiba M: Dural landmark to locate the internal auditory canal in large and giant vestibular schwannomas: the T\u00fcbingen line. Neurosurgery 69 (1 Suppl Operative):ons99\u2013ons102, 201110.1097\/00006123-200009001-00013"},{"key":"b5","series-title":"Br J Neurosurg","doi-asserted-by":"publisher","first-page":"288","DOI":"10.1080\/02688690701397773","article-title":"Superior petrosal vein in trigeminal neuralgia","volume":"21","author":"Choudhari KA","year":"2007","unstructured":"Choudhari KA: Superior petrosal vein in trigeminal neuralgia. Br J Neurosurg 21:288\u2013292, 20071761292010.1080\/02688690701397773"},{"key":"b6","series-title":"Clin Neurol Neurosurg","doi-asserted-by":"publisher","first-page":"844","DOI":"10.1016\/j.clineuro.2011.06.003","article-title":"Microvascular decompression surgery for trigeminal neuralgia and hemifacial spasm: naunces of the technique based on experiences with 100 patients and review of the literature","volume":"113","author":"Cohen-Gadol AA","year":"2011","unstructured":"Cohen-Gadol AA: Microvascular decompression surgery for trigeminal neuralgia and hemifacial spasm: naunces of the technique based on experiences with 100 patients and review of the literature. Clin Neurol Neurosurg 113:844\u2013853, 201110.1016\/j.clineuro.2011.06.00321752534"},{"key":"b7","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, 200810.1111\/j.1468-1331.2008.02185.x18721143"},{"key":"b8","series-title":"Neurol Res","doi-asserted-by":"publisher","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":"Feng B","year":"2015","unstructured":"Feng B, Zheng X, Wang X, Wang X, Ying T, Li S: Management of different kinds of veins during microvascular decompression for trigeminal neuralgia: technique notes. Neurol Res 37:1090\u20131095, 20152692357910.1080\/01616412.2015.1115588"},{"key":"b9","series-title":"Br J Neurosurg","doi-asserted-by":"publisher","first-page":"531","DOI":"10.1080\/02688690020005536","article-title":"Combined transhorizontal-supracerebellar approach for microvascular decompression of trigeminal neuralgia","volume":"14","author":"Fujimaki T","year":"2000","unstructured":"Fujimaki T, Kirino T: Combined transhorizontal-supracerebellar approach for microvascular decompression of trigeminal neuralgia. Br J Neurosurg 14:531\u2013534, 20001127203010.1080\/02688690020005536"},{"key":"b10","series-title":"Cephalalgia Int J Headache","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1097\/00006123-200009001-00013","article-title":"The International Classification of Headache Disorders, 3rd edition (beta version)","volume":"33","year":"2013","unstructured":"Headache Classification Committee of the International Headache Society (IHS): The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia Int J Headache 33:629\u2013808, 201310.1097\/00006123-200009001-00013"},{"key":"b11","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"1436","DOI":"10.1227\/01.NEU.0000093431.43456.3B","article-title":"Microvascular decompression for treatment of trigeminal neuralgia, hemifacial spasm, and glossopharyngeal neuralgia: three surgical approach variations: technical note","volume":"53","author":"Hitotsumatsu T","year":"2003","unstructured":"Hitotsumatsu T, Matsushima T, Inoue T: Microvascular decompression for treatment of trigeminal neuralgia, hemifacial spasm, and glossopharyngeal neuralgia: three surgical approach variations: technical note. Neurosurgery 53:1436\u20131443, 20031463331310.1227\/01.NEU.0000093431.43456.3B"},{"issue":"5","key":"b12","series-title":"Neurosurg Focus","doi-asserted-by":"publisher","first-page":"E5","DOI":"10.3171\/foc.2005.18.5.6","article-title":"Technique of microvascular decompression. Technical note","volume":"18","author":"Jannetta PJ","year":"2005","unstructured":"Jannetta PJ, McLaughlin MR, Casey KF: Technique of microvascular decompression. Technical note. Neurosurg Focus 18(5):E5, 200510.3171\/foc.2005.18.5.615913281"},{"key":"b13","series-title":"World Neurosurg","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1016\/j.wneu.2015.11.025","article-title":"The retrosigmoid petrosal fissure transpeduncular approach to central pontine lesions","volume":"87","author":"Kalani MY","year":"2016","unstructured":"Kalani MY, Yagmurlu K, Martirosyan NL, Spetzler RF: The retrosigmoid petrosal fissure transpeduncular approach to central pontine lesions. World Neurosurg 87:235\u2013241, 201610.1016\/j.wneu.2015.11.02526615787"},{"key":"b14","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"1251","DOI":"10.1227\/01.NEU.0000065129.25359.EE","article-title":"Microvascular decompression surgery in the United States, 1996 to 2000: mortality rates, morbidity rates, and the effects of hospital and surgeon volumes","volume":"52","author":"Kalkanis SN","year":"2003","unstructured":"Kalkanis SN, Eskandar EN, Carter BS, Barker FG II: Microvascular decompression surgery in the United States, 1996 to 2000: mortality rates, morbidity rates, and the effects of hospital and surgeon volumes. Neurosurgery 52:1251\u20131262, 200310.1227\/01.NEU.0000065129.25359.EE12762870"},{"key":"b15","series-title":"J Neurosurg","doi-asserted-by":"publisher","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":"Ko AL","year":"2015","unstructured":"Ko AL, Ozpinar A, Lee A, Raslan AM, McCartney S, Burchiel KJ: Long-term efficacy and safety of internal neurolysis for trigeminal neuralgia without neurovascular compression. J Neurosurg 122:1048\u20131057, 20152567928310.3171\/2014.12.JNS14469"},{"key":"b16","series-title":"Acta Neurochir (Wien)","doi-asserted-by":"publisher","first-page":"773","DOI":"10.1007\/s00701-012-1277-5","article-title":"A proposal for standardized analysis of the results of microvascular decompression for trigeminal neuralgia and hemifacial spasm","volume":"154","author":"Kondo A","year":"2012","unstructured":"Kondo A, Date I, Endo S, Fujii K, Fujii Y, Fujimaki T, : A proposal for standardized analysis of the results of microvascular decompression for trigeminal neuralgia and hemifacial spasm. Acta Neurochir (Wien) 154:773\u2013778, 20122232732510.1007\/s00701-012-1277-5"},{"key":"b17","series-title":"J Clin Neurosci","doi-asserted-by":"publisher","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":"Masuoka J","year":"2009","unstructured":"Masuoka J, Matsushima T, Hikita T, Inoue E: Cerebellar swelling after sacrifice of the superior petrosal vein during microvascular decompression for trigeminal neuralgia. J Clin Neurosci 16:1342\u20131344, 20091957678010.1016\/j.jocn.2008.12.024"},{"key":"b18","series-title":"Neurocirugia (Astur)","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1016\/j.neucir.2012.09.004","article-title":"[Neurosurgical importance of the superior petrosal venous complex.]","volume":"24","author":"Monroy-Sosa A","year":"2013","unstructured":"Monroy-Sosa A, Mendoza-Falc\u00f3n G, Mac\u00edas-Duvignau MA, Reyes-Soto G, Cardenas-Garc\u00eda Y, Mendiz\u00e1bal-Guerra R, : [Neurosurgical importance of the superior petrosal venous complex.] Neurocirugia (Astur) 24:70\u201377, 2013 (Span)10.1016\/j.neucir.2012.09.00423199795"},{"issue":"6 Suppl Operative","key":"b19","series-title":"Neurosurgery","first-page":"306","article-title":"Retrosigmoid suprafloccular transhorizontal fissure approach for resection of brainstem cavernous malformation","volume":"66","author":"Ohue S","year":"2010","unstructured":"Ohue S, Fukushima T, Friedman AH, Kumon Y, Ohnishi T: Retrosigmoid suprafloccular transhorizontal fissure approach for resection of brainstem cavernous malformation. Neurosurgery 66 (6 Suppl Operative):306\u2013313, 201020489521"},{"issue":"3 Suppl","key":"b20","series-title":"Neurosurgery","first-page":"S93","article-title":"The cerebellopontine angle and posterior fossa cranial nerves by the retrosigmoid approach","volume":"47","author":"Rhoton AL Jr","year":"2000","unstructured":"Rhoton AL Jr: The cerebellopontine angle and posterior fossa cranial nerves by the retrosigmoid approach. Neurosurgery 47 (3 Suppl):S93\u2013S129, 2000"},{"issue":"3 Suppl","key":"b21","series-title":"Neurosurgery","first-page":"S7","article-title":"Cerebellum and fourth ventricle","volume":"47","author":"Rhoton AL Jr","year":"2000","unstructured":"Rhoton AL Jr: Cerebellum and fourth ventricle. Neurosurgery 47 (3 Suppl):S7\u2013S27, 2000"},{"issue":"Suppl 3","key":"b22","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"420","DOI":"10.1227\/NEU.0000000000000853","article-title":"Usefulness of a virtual reality percutaneous trigeminal rhizotomy simulator in neurosurgical training","volume":"11","author":"Shakur SF","year":"2015","unstructured":"Shakur SF, Luciano CJ, Kania P, Roitberg BZ, Banerjee PP, Slavin KV, : Usefulness of a virtual reality percutaneous trigeminal rhizotomy simulator in neurosurgical training. Neurosurgery 11 (Suppl 3):420\u2013425, 20152610344410.1227\/NEU.0000000000000853"},{"key":"b23","series-title":"World Neurosurg","doi-asserted-by":"publisher","first-page":"378","DOI":"10.1016\/j.wneu.2012.05.030","article-title":"Detection of compression vessels in trigeminal neuralgia by surface-rendering three-dimensional reconstruction of 1.5- and 3.0-T magnetic resonance imaging","volume":"80","author":"Shimizu M","year":"2013","unstructured":"Shimizu M, Imai H, Kagoshima K, Umezawa E, Shimizu T, Yoshimoto Y: Detection of compression vessels in trigeminal neuralgia by surface-rendering three-dimensional reconstruction of 1.5- and 3.0-T magnetic resonance imaging. World Neurosurg 80:378\u2013385, 201310.1016\/j.wneu.2012.05.03023022639"},{"key":"b24","series-title":"World Neurosurg","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1016\/j.wneu.2010.06.008","article-title":"Operative strategies for minimizing hearing loss associated with microvascular decompression for trigeminal neuralgia","volume":"74","author":"Sindou M","year":"2010","unstructured":"Sindou M: Operative strategies for minimizing hearing loss associated with microvascular decompression for trigeminal neuralgia. World Neurosurg 74:111\u2013112, 201010.1016\/j.wneu.2010.06.00821299996"},{"issue":"4 Suppl 2","key":"b25","series-title":"Neurosurgery","first-page":"341","article-title":"Microvascular decompression for trigeminal neuralgia: the importance of a noncompressive technique\u2014Kaplan-Meier analysis in a consecutive series of 330 patients","volume":"63","author":"Sindou M","year":"2008","unstructured":"Sindou M, Leston JM, Decullier E, Chapuis F: Microvascular decompression for trigeminal neuralgia: the importance of a noncompressive technique\u2014Kaplan-Meier analysis in a consecutive series of 330 patients. Neurosurgery 63 (4 Suppl 2):341\u2013351, 2008"},{"key":"b26","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"1500","DOI":"10.3171\/2014.10.JNS141101","article-title":"The incidence of high-frequency hearing loss after microvascular decompression for trigeminal neuralgia, glossopharyngeal neuralgia, or geniculate neuralgia","volume":"123","author":"Thirumala P","year":"2015","unstructured":"Thirumala P, Meigh K, Dasyam N, Shankar P, Sarma KR, Sarma DR, : The incidence of high-frequency hearing loss after microvascular decompression for trigeminal neuralgia, glossopharyngeal neuralgia, or geniculate neuralgia. J Neurosurg 123:1500\u20131506, 20152593261210.3171\/2014.10.JNS141101"},{"key":"b27","series-title":"Neurol Res","doi-asserted-by":"publisher","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":"Zhong J","year":"2014","unstructured":"Zhong J, Zhu J, Sun H, Dou NN, Wang YN, Ying TT, : Microvascular decompression surgery: surgical principles and technical nuances based on 4000 cases. Neurol Res 36:882\u2013893, 201410.1179\/1743132814Y.000000034424597913"},{"key":"b28","series-title":"J Craniofac Surg","doi-asserted-by":"publisher","first-page":"1438","DOI":"10.1097\/SCS.0000000000000780","article-title":"Via-cerebellar-fissures approach for microvascular decompression of trigeminal nerve","volume":"25","author":"Zhu J","year":"2014","unstructured":"Zhu J, Zhong J, Jiao W, Zhou QM, Guan HX, Dou NN, : Via-cerebellar-fissures approach for microvascular decompression of trigeminal nerve. J Craniofac Surg 25:1438\u20131440, 201410.1097\/SCS.000000000000078025006920"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/129\/2\/article-p324.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/129\/2\/article-p324.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/129\/2\/article-p324.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,31]],"date-time":"2025-03-31T02:53:31Z","timestamp":1743389611000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/129\/2\/article-p324.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,8]]},"references-count":28,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.3171\/2017.5.jns17515","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,8]]}}}