Late Results of Gangliolysis as a Treatment for Trigeminal Neuralgia

p ROCEEDING from the assumption that trigeminal neuralgia may be caused by a space-narrowing process in the posterior cranial fossa and may be cured by surgical removal of that process, TaarnhCj 26 suggested that of the trigeminal root in the area of the porus trigemini might cause trigeminal neuralgia. His operative decompressions of this region were followed by relief of pain. The special advantage of this technique, compared with other methods practiced, proved to be the absence of unpleasant postoperative sensory defects. By modifying and simplifying TaarnhCj's method, Stender 22,23 and Schwartz 17 independantly introduced in this procedure the Gasserian ganglion and the pars triangularis of the root were merely released from their dural coverings. Shelden, ls,2~ assuming that the success obtained by decompression might be attributed to traumatization of the trigeminal root, described a further successful operative method, namely, compression of the root. Taking this into consideration we have added, since 1956, application of 70% alcohol to the root in the procedure of gangliolysis; this has produced greater traumatization of the root and a more pronounced sensory loss. The postoperative results following each of these various compressive or decompressive surgical procedures were encouraging at firstg,14,2~,26; however, later within shorter periods than had been expected relapses occurred necessitating reoperation (Table 1).