Int. Adv. Otol. 2010; 6(3) 316-319

Endoscopy assisted microvascular decompression for vascular conflict syndromes in 22 patients.
Yildirim A. Bayazit, Tolga Catli, Nebil Goksu.Gazi University Otolaryngology Dept. Turkey.

Objective: To present the results of our clinical experience with endoscope assisted vascular decompression performed for different vascular conflict disorders such as hemifacial spasm, trigeminal neuralgia, tinnitus, and trigeminal neuralgia plus disabling positional vertigo.

Methods: There were 22 decompressions performed between 1999 and 2008 (7 men and 15 women with ages ranging from 24 to 77 years). An endoscope assisted retrosigmoid approach was used in the surgeries.

Results:  Eighteen of 22 patients had complete relief of the symptoms, and 3 had a partial and one had no relief in the symptoms. No perioperative complication was encountered. The major compressing vessels were anterior inferior cerebellar artery (AICA) in 8 patients, vertebal artery (VA) in 6 patients, superior cerebellar artery (SCA) in 2 patients, posterior inferior cerebellar artery (PICA) in 4 patients, and both AICA and VA in 2 patients. Two patients have become normotensive after decompression of the left medulla oblongata as well.

Conclusion: Microvascular decompression provides a significant relief in the alleviation of the symptoms of the patients who had conflict syndromes. Endoscopes, especially 45 degree, act as an adjunct to microscope in the precision of the offending vessel in the root entry zone.