{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T11:20:07Z","timestamp":1768216807944,"version":"3.49.0"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T00:00:00Z","timestamp":1768176000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Recurrence of trigeminal neuralgia (TN) after microvascular decompression (MVD) poses a challenge for neurosurgeons. This study aimed to investigate the effect of repeat posterior fossa exploration (RPFE) and external neurolysis for TN recurrence following MVD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Totally, 38 TN patients who experienced recurrence after MVD were included. All patients underwent RPFE and limited neurolysis. The Barrow Neurological Institute Pain Intensity Scale were utilized to evaluate preoperative pain and postoperative outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The median follow-up period was 63.8 months (range: 5\u2013112 months). Thirty-three out of the 38 patients achieved excellent outcomes, 4 had good outcomes, and 1 experienced failure. The rates of complete pain relief was 92% immediately post-surgery and 86.8% at the final follow-up. Re-exploration revealed Teflon adhesion in almost all patients (92%). Complications included new facial numbness (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20095), temporary facial weakness (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20093), hearing loss and tinnitus (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091), wound infection (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091), and postoperative hemorrhage (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Teflon adhesion was frequently observed upon re-exploration. A substantial majority of TN patients experiencing recurrence post-MVD achieved positive outcomes via RPFE and neurolysis. Complications, particularly facial numbness attributed to premature excessive Teflon dislodgement, continue to pose challenges. However, limited neurolysis, have proven effective in minimizing these complications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2025.1694389","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T08:16:48Z","timestamp":1768205808000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Repeat posterior fossa exploration and external neurolysis for recurrent trigeminal neuralgia following microvascular decompression"],"prefix":"10.3389","volume":"12","author":[{"given":"Zhong","family":"Liu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiao","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ming-Liang","family":"Ren","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Min-Hui","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sha","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xu-Zhi","family":"He","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xu-Hui","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,12]]},"reference":[{"key":"B1","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","journal-title":"N Engl J Med"},{"key":"B2","doi-asserted-by":"publisher","first-page":"2347","DOI":"10.1093\/brain\/124.12.2347","article-title":"Trigeminal neuralgia: pathology and pathogenesis","volume":"124","author":"Love","year":"2001","journal-title":"Brain"},{"key":"B3","doi-asserted-by":"publisher","first-page":"e67","DOI":"10.1016\/j.wneu.2018.05.147","article-title":"Re-Exploration of microvascular decompression in recurrent trigeminal neuralgia and intraoperative management options","volume":"117","author":"Hussain","year":"2018","journal-title":"World Neurosurg"},{"key":"B4","doi-asserted-by":"publisher","first-page":"296","DOI":"10.1097\/WCO.0b013e328352c465","article-title":"Microvascular decompression for trigeminal neuralgia: update","volume":"25","author":"Zakrzewska","year":"2012","journal-title":"Curr Opin Neurol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"e67","DOI":"10.1016\/j.wneu.2022.03.128","article-title":"Microvascular decompression: a bibliometric analysis of the 100 most cited articles","volume":"164","author":"Wolff Fernandes","year":"2022","journal-title":"World Neurosurg"},{"key":"B6","doi-asserted-by":"publisher","first-page":"787","DOI":"10.1016\/j.jocn.2005.08.001","article-title":"Microvascular decompression for trigeminal neuralgia: recurrences and complications","volume":"12","author":"Olson","year":"2005","journal-title":"J Clin Neurosci"},{"key":"B7","doi-asserted-by":"publisher","first-page":"738032","DOI":"10.3389\/fneur.2021.738032","article-title":"Recurrence rates after microvascular decompression in patients with primary trigeminal neuralgia and its influencing factors: a systematic review and meta-analysis based on 8,172 surgery patients","volume":"12","author":"Chen","year":"2021","journal-title":"Front Neurol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"e612","DOI":"10.1016\/j.wneu.2021.11.033","article-title":"Teflon granuloma: a common cause of recurrent trigeminal neuralgia","volume":"158","author":"Sun","year":"2022","journal-title":"World Neurosurg"},{"key":"B9","doi-asserted-by":"publisher","first-page":"584224","DOI":"10.3389\/fneur.2020.584224","article-title":"Long-Term retrospective analysis of microvascular decompression in patients with recurrent trigeminal neuralgia","volume":"11","author":"Liu","year":"2020","journal-title":"Front Neurol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"3877","DOI":"10.1007\/s00701-023-05877-z","article-title":"Microsurgical posterior fossa re-exploration for recurrent trigeminal neuralgia after previous microvascular decompression: common grounds-scarring, deformation, and the \u201cpiston effect\u201d","volume":"165","author":"Hatipoglu Majernik","year":"2023","journal-title":"Acta Neurochir (Wien)"},{"key":"B11","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1007\/s007010050469","article-title":"Recurrent trigeminal neuralgia after microvascular decompression using an interposing technique. 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