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Before I point out the reasons why Skull Base Institute leads in performing Trigeminal Neuralgia surgery, I would like to define Trigeminal neuralgia (TN) first.

Trigeminal Neuralgia is a pain syndrome characterized by irregular, shooting pain, which can be best described as intense, sharp, episodic, periodical, excruciating, stabbing and short lasting and often accompanied by a brief facial spasm or tic in the face along the distribution of the fifth (trigeminal) cranial nerve; while Neuralgia, simply means pain. Usually, this pain is restricted or can only be felt on one side of the face,

TN is distinct but can sometimes be confused with similar conditions like atypical facial pain, glossopharyngeal neuralgia, temporomandibular joint pain, sinusitis, migraine headache, other forms of neuritis, and dental problems; thus it should be clearly identified for accurate diagnosis and in order to work with effective remedies.

When Trigeminal Neuralgia is already ruled out, surgical operation is often considered; but there are two types of surgical procedures done to relieve the patient with this kind of excruciating pain: these are the non-destructive procedures and destructive procedures.

Destructive Procedures
Several destructive surgical procedures, by damaging the trigeminal nerve fibers, have already been done to treat TN and the most common are glycerol injections, gamma knife radiation, electrocoagulation, and balloon compression. Sometimes, permanent damage may result from this destructive procedure.

Non-Destructive Procedures
Surgical decompression of the trigeminal nerve is the only non destructive procedure that can get rid of the patient’s agony due to this condition. This procedure can be done either by open surgery or endoscopically. This type of procedure lessens the patient’s burden and has already been proven to be reliable and effective.

This is where Skull Base Institute (SBI) plays its major role by providing the patients with fewer complications, far less pain and faster recovery as compared with other institutions that offer TN surgery. What makes SBI lead in this field is that their director, Dr. Shahinian, is the only surgeon as of today to have done a lengthier and more specialized training to include skull base, craniofacial and microvascular fellowships.

He personally performs TN surgery through a dime-size keyhole opening behind the ear where he inserts a 2.7 mm endoscope. The procedure involves surgical exploration with direct visualization of the trigeminal nerve at its junction with the pons, followed by moving away any compressing blood vessels and padding the nerve with a small piece of Teflon.

In many cases, the endoscopic Keyhole Surgery for trigeminal neuralgia is the preferred approach over other methods where metal retractors and other instruments are inserted thru a much larger opening behind the ear, and the brain is pushed aside to reach the nerve compression area. The advantage of this procedure done by Skull Base Institute is less pain and complication to the patients.