{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:17:28Z","timestamp":1787840248951,"version":"build-2784847793"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                    <jats:p>Petrous endostosis or prominent suprameatal tubercle is a rare entity which may prevent adequate microscopic exposure of the trigeminal nerve root entry zone during microvascular decompression (MVD) for trigeminal neuralgia. We present a rare case of trigeminal neuralgia (TN) with petrous endostosis, which was managed adequately by partial removal of the prominent suprameatal tubercle to improve the obscured site of neurovascular conflict and enabled complete MVD. Through this manuscript, we additionally discuss the nuances involved in this extension of the standard retrosigmoid approach in light of the published literature. Petrous endostosis encountered during MVD for TN can impose an operative challenge. Suprameatal extension of the standard retrosigmoid approach improves exposure at the site of neurovascular conflict but requires utmost care and attention to avoid complications. We emphasize recognizing this anatomical variation in the preoperative period to predict an operative difficulty, ensure appropriate patient counselling, and avoiding surgical complications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/0028-3886.349582","type":"journal-article","created":{"date-parts":[[2023,8,24]],"date-time":"2023-08-24T03:55:57Z","timestamp":1692849357000},"page":"1240-1243","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":5,"title":["Suprameatal Extension of Retrosigmoid Approach in Microvascular Decompression for Trigeminal Neuralgia with Petrous Endostosis"],"prefix":"10.4103","volume":"70","author":[{"given":"Nitish","family":"Agarwal","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amandeep","family":"Kumar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pankaj","family":"Singh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P S","family":"Chandra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shashank S","family":"Kale","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-74-20241013","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1002\/ca.22157","article-title":"The anatomy of vascular compression in trigeminal neuralgia","volume":"27","author":"Thomas","year":"2014","journal-title":"Clin Anat"},{"key":"R2-74-20241013","doi-asserted-by":"crossref","first-page":"1037","DOI":"10.1007\/s00701-011-0957-x","article-title":"Clinical features and surgical treatment of trigeminal neuralgia caused solely by venous compression","volume":"153","author":"Hong","year":"2011","journal-title":"Acta Neurochir (Wien"},{"key":"R3-74-20241013","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1007\/s10072-013-1518-2","article-title":"Arterial compression of nerve is the primary cause of trigeminal neuralgia","volume":"35","author":"Chen","year":"2014","journal-title":"Neurol Sci"},{"key":"R4-74-20241013","doi-asserted-by":"crossref","first-page":"585","DOI":"10.4103\/ajns.AJNS_67_14","article-title":"Trigeminal Neuralgia","volume":"12","author":"Yadav","year":"2017","journal-title":"Asian J Neurosurg"},{"key":"R5-74-20241013","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/S1058-9139(05)80246-3","article-title":"Vascular compression is the cause of trigeminal neuralgia","volume":"2","author":"Jannetta","year":"1993","journal-title":"APS J"},{"key":"R6-74-20241013","doi-asserted-by":"crossref","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":"R7-74-20241013","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3171\/jns.1999.90.1.0001","article-title":"Microvascular decompression of cranial nerves: Lessons learned after 4400 operations","volume":"90","author":"McLaughlin","year":"1999","journal-title":"J Neurosurg"},{"key":"R8-74-20241013","doi-asserted-by":"crossref","first-page":"1111","DOI":"10.1097\/00006123-199811000-00061","article-title":"Posterior fossa reexploration for persistent or recurrent trigeminal neuralgia or hemifacial spasm: Surgical findings and therapeutic implications","volume":"43","author":"Kureshi","year":"1998","journal-title":"Neurosurgery"},{"key":"R9-74-20241013","doi-asserted-by":"crossref","first-page":"E5","DOI":"10.3171\/foc.2005.18.5.6","article-title":"Technique of microvascular decompression. 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