{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T12:27:56Z","timestamp":1793795276772,"version":"4.6.1"},"reference-count":12,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1999,1]]},"abstract":"<jats:p content-type=\"fine-print\"><jats:italic>Object.<\/jats:italic> Microvascular decompression has become an accepted surgical technique for the treatment of trigeminal neuralgia, hemifacial spasm, glossopharyngeal neuralgia, and other cranial nerve rhizopathies. The senior author (P.J.J.) began performing this procedure in 1969 and has performed more than 4400 operations. The purpose of this article is to review some of the nuances of the technical aspects of this procedure.<\/jats:p><jats:p content-type=\"fine-print\"><jats:italic>Methods.<\/jats:italic> A review of 4415 operations shows that numerous modifications to the technique of microvascular decompression have occurred during the last 29 years. Of the 2420 operations performed for trigeminal neuralgia, hemifacial spasm, and glossopharyngeal neuralgia before 1990, cerebellar injury occurred in 21 cases (0.87%), hearing loss in 48 (1.98%), and cerebrospinal fluid (CSF) leakage in 59 cases (2.44%). Of the 1995 operations performed since 1990, cerebellar injuries declined to nine cases (0.45%), hearing loss to 16 (0.8%), and CSF leakage to 37 (1.85% p &lt; 0.01, test for equality of distributions). The authors describe slight variations made to maximize surgical exposure and minimize potential complications in each of the six principal steps of this operation. These modifications have led to decreasing complication rates in recent years.<\/jats:p><jats:p content-type=\"fine-print\"><jats:italic>Conclusions.<\/jats:italic> Using the techniques described in this report, microvascular decompression is an extremely safe and effective treatment for many cranial nerve rhizopathies.<\/jats:p>","DOI":"10.3171\/jns.1999.90.1.0001","type":"journal-article","created":{"date-parts":[[2009,5,13]],"date-time":"2009-05-13T17:26:30Z","timestamp":1242235590000},"page":"1-8","source":"Crossref","is-referenced-by-count":578,"title":["Microvascular decompression of cranial nerves: lessons learned after 4400 operations"],"prefix":"10.3171","volume":"90","author":[{"given":"Mark R.","family":"McLaughlin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter J.","family":"Jannetta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brent L.","family":"Clyde","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian R.","family":"Subach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher H.","family":"Comey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel K.","family":"Resnick","sequence":"additional","affiliation":[],"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","year":"1996"},{"key":"b2","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"201","DOI":"10.3171\/jns.1995.82.2.0201","article-title":"Microvascular decompression for hemifacial spasm.","volume":"82","author":"Barker","year":"1995"},{"key":"b3","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"342","DOI":"10.3171\/jns.1947.4.4.0342","article-title":"Hemifacial spasm: a note on the etiology in two cases.","volume":"4","author":"Campbell","year":"1947"},{"key":"b4","series-title":"Am J Surg","doi-asserted-by":"publisher","first-page":"447","DOI":"10.1016\/S0002-9610(34)90403-7","article-title":"Concerning the cause of trigeminal neuralgia.","volume":"24","author":"Dandy","year":"1934"},{"key":"b5","series-title":"Arch Surg","doi-asserted-by":"publisher","first-page":"687","DOI":"10.1001\/archsurg.1929.04420030081005","article-title":"An operation for the cure of tic douloureux. 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Discussion of cause of trigeminal neuralgia.","volume":"170","author":"Gardner","year":"1959"},{"key":"b9","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"240","DOI":"10.3171\/jns.1962.19.3.0240","article-title":"Hemifacial spasm\u2014a reversible pathophysiologic state.","volume":"19","author":"Gardner","year":"1962"},{"key":"b10","series-title":"Rev Neurol","first-page":"38","article-title":"Hemispasme facial gu\u00e9ri par intervention sur la fossa post\u00e9rieure.","volume":"80","author":"Laine","year":"1948"},{"key":"b11","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1227\/00006123-199501000-00008","article-title":"Microvascular decompression for glossopharyngeal neuralgia.","volume":"36","author":"Resnick","year":"1995"},{"key":"b12","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"288","DOI":"10.3171\/jns.1952.9.3.0288","article-title":"Decompression of the trigeminal root and the posterior part of the ganglion as treatment in trigeminal neuralgia. 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