Decompression / Jannetta surgery

The Jannetta procedure was firstly described by a neurosurgeon called Jannetta, from whom the name of the method stems. He observed that a small arteria proceeds near the origin of the trigeminal nerve, the brainstem. This holds only for people suffering from tigeminal neuralgia, but not for healthy persons. Jannetta concluded that the pulsation of this arteria could harm the nerve since it has no protecting shell at his origin in the brainstem. To treat trigeminal neuralgia, he placed muscular or artificial tissue between arteria and nerve, and, thus, was able to produce a long-term solution in more than 70% of the cases.
The decompression of the trigeminal nerve after Jannetta is conducted microsurgically by employing a high-resolution microscope. Although the skull is opened, patients are completely mobile after a few days (inpatient stay for 4-5 days). Often the relief of pain is perceived one day after surgery. The risk of the procedure is only slight given that an experienced neurosurgeon performs the decompression. Facing the extreme impairment of quality of life and the unbearably pain, the decompression of the trigeminal nerve after Jannetta is indicated with regard to a symptomatic trigeminal neuralgia and unsuccessful drug treatment. Permanent pain relief without taking any drugs is possible for 91% one year and 73% fifteen years after the decompression of trigeminal nerve after Jannetta (Literature: Sindou M, Leston J, Decullier E, Chapuis F.: Microvascular decompression for primary trigeminal neuralgia: long-term effectiveness and prognostic factors in a series of 362 consecutive patients with clear-cut neurovascular conflicts who underwent pure decompression. J Neurosurg. 2007 Dec;107(6):1144-53; Barker FG 2nd, Jannetta PJ, Bissonette DJ, Larkins MV, Jho HD: The long-term outcome of microvascular decompression for trigeminal neuralgia. N Engl J Med. 1996 Apr 25;334(17):1077-83; comment in N Engl J Med. 1996 Apr 25;334(17):1125-6).