Classic trigeminal neuralgia is based on a neurovascular conflict of the trigeminal nerve. Nowadays microvascular decompression according to Jannetta (MVD) is a standard therapy. The interposition using Teflon patches is most common in the literature. In our neurosurgica departement we use a Goretex-Loop for relocation and fixation of the compressive vessels. In this work we present one large cohort regarding Goretex-Loops in MVD.

The present study included all eligable patients who underwent MVD according to Jannetta due to trigeminal neuralgia in our clinic between 2010 and 2023. A retrospective analysis of patient records and perioperative data was performed. In addition, the patients were recently contacted to enable long-term follow-up. Collected data include demographic information, clinical symptoms, operative details and postoperative outcomes.

Between 2010 and 2023 n=256 MVDs according to Jannetta were eligable. The averageage was 60 (+/-10) years. The ratio of female to men was 56:44. 8% were revision surgeries. The average time of surgery was 162 (+/-16.3) minutes, possible due to the used loop technique. With overall low complication rates, temporary hypoesthesia was the most common. The complication rate of 2% corresponds to the data in the literature. On average, 87% (n=224) of patients reported a significant improvement immediatly postoperatively, including complete regression of the pain. The pain medication could be discontinued after an average of 4.25 months. Recurrences (pain comparable to preoperative or worse) occurred in a total of 17% (n=44) over the long term follow-up. In addition, 27% (n=69%) patients experienced renewed pain, although this was significantly less severe than preoperatively. The median follow-up time is 66 months (2-162 months).

We present a large case series of microvascular decompression according to Jannetta for trigeminal neuralgia using a Goretex-Loop. A total of 257 surgical procedures were performed. We show using a Goretex-Loop with the aim of relocation of compressiv vessels and interposition is a safe and very effective method.