Neurovascular decompression with selective partial rhizotomy of the trigeminal nerve for tic douloureux

Fourteen patients with classic tic douloureux were treated with neurovascular decompression of the trigeminal nerve at its zone of entry into the pons. In addition, selective rhizotomy of the portio major was performed in each patient. This combined procedure gave excellent relief of pain with no recurrences in a 23-month postoperative period. Technical observations and postoperative complications in 3 patients are discussed. Routine selective partial rhizotomy of the sensory root of the trigeminal nerve may be a useful adjunct to neurovascular decompression for tic douloureux.