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Long-term effectiveness of an ad hoc tailored titanium implant as a spacer for microvascular decompression in the treatment of trigeminal neuralgia caused by megadolichoectatic basilar artery anomaly: 9-year follow-up.
J Neurosurg. 2014 Dec; 121(6):1492-6.JN

Abstract

An enlarged, elongated, ectatic, and sclerotic aberration of the vertebrobasilar system is known as a megadolichoectatic basilar artery (BA) anomaly. The anomaly is often involved in the pathological process of trigeminal neuralgia by compressing and distorting the trigeminal nerve. First-line medical treatment includes drug therapy, but a second-line surgical procedure could be effective in medication-resistant cases. The authors report the case of a 65-year-old man with a 12-year history of progressing trigeminal neuralgia who underwent microvascular decompression after the first-line drug treatment had failed. This case is unique because an in situ tailored titanium microplate was used as a spacer to alleviate compression by the BA on the trigeminal nerve. The titanium implant provided durable and sufficient retraction for the sclerotic arterial complex when the trigeminal nerve was placed in the tunnel of the implant. The 9-year follow-up examination proves the safety and long-term efficacy of titanium implants in the treatment of trigeminal neuralgia caused by a megadolichoectatic BA anomaly. The method applied in this case was not intended to be and certainly is not an alternative to routine microvascular decompression-this surgical solution may be reserved for some extreme cases.

Authors+Show Affiliations

National Institute of Neurosurgery, and.No affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

25259563

Citation

Banczerowski, Péter, et al. "Long-term Effectiveness of an Ad Hoc Tailored Titanium Implant as a Spacer for Microvascular Decompression in the Treatment of Trigeminal Neuralgia Caused By Megadolichoectatic Basilar Artery Anomaly: 9-year Follow-up." Journal of Neurosurgery, vol. 121, no. 6, 2014, pp. 1492-6.
Banczerowski P, Czigléczki G, Nyáry I. Long-term effectiveness of an ad hoc tailored titanium implant as a spacer for microvascular decompression in the treatment of trigeminal neuralgia caused by megadolichoectatic basilar artery anomaly: 9-year follow-up. J Neurosurg. 2014;121(6):1492-6.
Banczerowski, P., Czigléczki, G., & Nyáry, I. (2014). Long-term effectiveness of an ad hoc tailored titanium implant as a spacer for microvascular decompression in the treatment of trigeminal neuralgia caused by megadolichoectatic basilar artery anomaly: 9-year follow-up. Journal of Neurosurgery, 121(6), 1492-6. https://doi.org/10.3171/2014.8.JNS132445
Banczerowski P, Czigléczki G, Nyáry I. Long-term Effectiveness of an Ad Hoc Tailored Titanium Implant as a Spacer for Microvascular Decompression in the Treatment of Trigeminal Neuralgia Caused By Megadolichoectatic Basilar Artery Anomaly: 9-year Follow-up. J Neurosurg. 2014;121(6):1492-6. PubMed PMID: 25259563.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term effectiveness of an ad hoc tailored titanium implant as a spacer for microvascular decompression in the treatment of trigeminal neuralgia caused by megadolichoectatic basilar artery anomaly: 9-year follow-up. AU - Banczerowski,Péter, AU - Czigléczki,Gábor, AU - Nyáry,István, Y1 - 2014/09/26/ PY - 2014/9/27/entrez PY - 2014/9/27/pubmed PY - 2015/1/28/medline KW - AICA = anterior inferior cerebellar artery KW - BA = basilar artery KW - CTA = CT angiography KW - MVD = microvascular decompression KW - SCA = superior cerebellar artery KW - TN = trigeminal neuralgia KW - VA = vertebral artery KW - functional neurosurgery KW - long-term effectiveness KW - megadolichoectatic basilar artery anomaly KW - microvascular decompression KW - titanium implant KW - trigeminal neuralgia SP - 1492 EP - 6 JF - Journal of neurosurgery JO - J Neurosurg VL - 121 IS - 6 N2 - An enlarged, elongated, ectatic, and sclerotic aberration of the vertebrobasilar system is known as a megadolichoectatic basilar artery (BA) anomaly. The anomaly is often involved in the pathological process of trigeminal neuralgia by compressing and distorting the trigeminal nerve. First-line medical treatment includes drug therapy, but a second-line surgical procedure could be effective in medication-resistant cases. The authors report the case of a 65-year-old man with a 12-year history of progressing trigeminal neuralgia who underwent microvascular decompression after the first-line drug treatment had failed. This case is unique because an in situ tailored titanium microplate was used as a spacer to alleviate compression by the BA on the trigeminal nerve. The titanium implant provided durable and sufficient retraction for the sclerotic arterial complex when the trigeminal nerve was placed in the tunnel of the implant. The 9-year follow-up examination proves the safety and long-term efficacy of titanium implants in the treatment of trigeminal neuralgia caused by a megadolichoectatic BA anomaly. The method applied in this case was not intended to be and certainly is not an alternative to routine microvascular decompression-this surgical solution may be reserved for some extreme cases. SN - 1933-0693 UR - https://www.unboundmedicine.com/medline/citation/25259563/Long_term_effectiveness_of_an_ad_hoc_tailored_titanium_implant_as_a_spacer_for_microvascular_decompression_in_the_treatment_of_trigeminal_neuralgia_caused_by_megadolichoectatic_basilar_artery_anomaly:_9_year_follow_up_ DB - PRIME DP - Unbound Medicine ER -