Retrosigmoid Craniectomy for Resection of Epidermoid causing Trigeminal Neuralgia
The differential diagnosis for trigeminal neuralgia like-symptoms includes cerebellopontine angle lesions causing regional mass effect upon the trigeminal nerve ( Fig. 1 ). Here we present an operative video manuscript of a patient experiencing trigeminal neuralgia, secondary to an epidermoid cyst, in which a retrosigmoid craniectomy was performed to resect the epidermoid and decompress the trigeminal nerve ( Fig. 2 ). This video highlights the operative nuances to achieving a successful surgery, including appropriate patient positioning, dural exposure to the transverse-sigmoid sinus junction, arachnoid dissection, and decompression of cranial nerves. A gross total resection was achieved; the patient reported immediate relief of facial pain postoperatively and has been pain free at the ten month follow-up. The link to the video can be found at: https://youtu.be/Ja2eE0uGk4E .
Amin, A., Wainwright, J., Gandhi, C., & Bowers, C. (2019). Retrosigmoid Craniectomy for Resection of Epidermoid causing Trigeminal Neuralgia. Journal of Neurological Surgery. Part B, Skull Base, 80 (Suppl 3), S320-S321. https://doi.org/10.1055/s-0038-1676998