Fedirko V. Diagnostics and surgical treatment of neurovascular-compression syndromes of cranial nerves

The dissertation is devoted to diagnostic and surgical treatment of neurovascular-compression syndromes of cranial nerves (NCS CN) such as trigeminal and glossopharyngeal neuralgia, hemifacial spasm, Menier's syndrome, paroxysmal arterial hypertention which present severe painful syndromes and hyperactive dysfunction of VII, VIII, X CN that leads to patient's professional and social disability. These syndromes persist for a long time with deteriorations, recurrences and progression and treatment modalities are not established. On the base of data of 430 patients with NCS CN diagnostics an treatment the necessity of at least two factors' simultaneous existence for NCS CN development was established. These are: 1) vascular compression of the nerve root which provokes local ischemia and postischemic changes and 2) immunodepression, autoneurosensibilisation. The treatment modalities were based on these factors of pathogenesis and included immunocorrection and microvascular decompression of CN in case of failed medical treatment. Surgery was performed with innovations based on microanatomical peculiarities established during research. New diagnostic methods application including intraoperative neuromonitoring and treatment modalities based on the established pathogenesis, complemented by new surgical methodologies, improved nearest treatment results up to 96,9% and long-term results - up to 89,2%.