Microvascular Decompression for Trigeminal Neuralgia in Very Elderly Patients

Background: Trigeminal neuralgia (TN) can trigger symptoms in activities of daily living (ADLs) that significantly limit and impair quality of life.Because eating is a trigger, eating disturbances due to TN can have a life-threatening impact on prognosis.In this study, we report a case of microvascular decompression (MVD) in patients with TN aged > 80 years. Materials and Methods:Eighteen patients aged > 80 years (80-90 years; 14 males and 4 females) underwent MVD for TN over the past two years.Surgery was performed using the retrosigmoid approach with continuous monitoring of the auditory brainstem response.To avoid stretching the eighth cranial nerve, which causes hearing loss, the spinal fluid was not drained too extensively, and decompression was applied after reaching the nerve.Intraoperative determination of the decompression method was performed using either transposition or interposition, with particular attention paid to the vessels responsible for arteriosclerosis.Results: Surgical results were favorable (94.4%), and no complications occurred.The average length of hospital stay was 10.6 days for the very elderly patients.Conclusions: Because of the excellent results obtained, we suggest that surgical treatment of very elderly patients should be aggressively considered after a thorough evaluation of the patient's general condition.