Clinical application of post mastoid transverse incision in keyhole microvascular decompression

Objective To explore the clinical value of post mastoid transverse incision in keyhole microvascular decompression (MVD) for cranial neuropathy. Methods Fifty-eight patients with trigeminal neuralgia, hemifacial spasm or glossopharyngeal neuralgia, admitted to and accepted postmastoid transverse incision keyhole surgery in our hospital from October 2015 to October 2017, were chosen. Their clinical data and efficacy were retrospectively analyzed. Results Lesions of cranial nerves in all 58 patients were exposed satisfactorily (trigeminal nerve, facial nerve, or glossopharyngeal nerve). Postoperative complications included severe facial numbness in one patient, scalp hydrops in one patient, ear discomfort in two patients, and hearing loss in two patients. No cerebrospinal fluid leakage or intracranial infection, no facial paralysis or ear deafness, no hoarseness or drinking cough, and no intracranial hemorrhage or death were observed. All patients were followed up for 3-24 months, enjoying total effective rate of 98.3% (57/58); and no recurrence or aggravation was noted. Conclusion MVD of post mastoid transverse incision in keyhole is a safe and effective surgical method for treatment of cranial nerve disorders; the steps of craniotomy and craniotomy in this method are simple, easy accessed, and fully neurologically exposed, having high surgical safety and good postoperative cosmetic results, which is worth of promoting application. Key words: Post mastoid approach; Transverse incision; Keyhole operation; Microvascular decompression surgery; Cranial nerve disease