[Developmental History of Microvascular Decompression Surgery for Cranial Nerve Dysfunction].

Abstract

Trigeminal neuralgia is characterized by severe lancinating pain in the face and hemifacial spasms displayed by continuous facial muscle twitching, which may impair a patient's quality of life. Before 1960, in the United States of America, the treatment of such symptoms was only partial rhizotomy of the cranial nerves, which resulted in postoperative complications.^{1, 2)} Afterwards, in the late 1960s, it became evident that the etiology of symptoms was an elicited arterial compression of the cranial nerves at the "Root Entry/Exit zone." Microvascular decompression(MVD)was introduced and finally became largely popularized by Gardner and Jannetta et al.^{3, 4)} In 1978, at the Neurosurgical Meeting in New York, I incidentally witnessed slides of MVD proposed by Jannetta, which gave me a big surprise since we were then treating such patients by old-fashioned rhizotomy. Despite much ignorance displayed even in the neurosurgical meeting, I started MVD in 1980.⁵⁾ In addition, in 1998 we held an Annual Meeting of the Japan Society for Microvascular Decompression Surgery, which has become more active in the fields of microsurgical techniques, diagnosis, monitoring, and long-term follow-up studies.^6-8) MVD is a functional neurosurgery and satisfactory results should entail a complete and permanent cure of symptoms without any postoperative sequelae. This makes MVD a sustainable surgery.