Nuances of Microvascular Decompression for Trigeminal Neuralgia

Mojgan Hodaie

May 09, 2022


Julio Cortes

Excellent! “Knowledge can be understood, rather than as a linear accumulation of facts, as the substitution of one worldview for another” - From the Structure of Scientific Revolutions - ▪️Thomas Kuhn.
Descriptions of Trigeminal Neuralgia date back to the 1st century, and Locke, André and Fothergill comprehensively characterised its clinical features in the 17th and 18th centuries. 44. Effective medical therapies for the episodic but painful condition would not be introduced for another 200 years. The disease, also called tic doloureux or neuralgia epileptiformis, gained the label “suicidal disease. “

Microvascular decompression surgery is the first-line surgical treatment for pneumonia.
first-line surgical treatment for conditions known as dysfunction syndromes.
as syndromes of hyperactive cranial nerve dysfunction, such as neuralgia epileptiformis, neuralgia epileptiformis or epileptiform neuralgia.
such as trigeminal neuralgia, hemifacial spasm and glossopharyngeal neuralgia.
facial spasm and glossopharyngeal neuralgia whenever drugs fail both due to insufficient and
drugs fail due to both insufficient and undesirable effects.
Dandy was the first to observe in 1932 that vascular compression of the trigeminal nerve in the posterior fossa could be the cause of painful tic.  Gardner and Sava in 1962 described vascular compression of the Seventh Cranial Nerve for hemifacial spasm. However, it was not until Jannetta on August 4, 1966 that she performed the first microvascular decompression in the book Working in a Very Small Place: The Making of a Neurosurgeon, author Shelton describes the three serendipitous events that came together in 1965-1966 to lead Jannetta to develop his understanding of neurovascular compression disorders, apply the surgical microscope known as the “Jannetta Procedure” and gain popularity over percutaneous and other direct methods of decompression.
percutaneous methods and the other existing direct interventions, as it is the only one
it is the only one that aims to eliminate pain while preserving the structural and functional integrity of the nerve.
structural and functional integrity of the nerve.

One of the neurological pathologies that occur in women, of paramount importance to offer certainty, confidence and peace of mind to patients and provide them with the best possible control of their disease, with the choice of therapy that allows them to achieve a balance in the risk-benefit ratio depending on the stage of life in which they find themselves.

Peter Joseph Jannetta & Thomas Kuhn. Jannetta accepted the challenge of introducing scientific and medical progress. He appreciated the ideas of Thomas Kuhn, a theoretical physicist who would teach an experimental science course for neuroscientists, wrote about how scientific communities react to change, and came to realise that the process was not unique to him or to neurosurgery.

Jannetta: “My misunderstanding of the acceptance process was naïve. But the young and naive see and do new things, partly because they don’t understand that something can’t be done. In The Structure of Scientific Revolutions, Thomas Kuhn clearly organised the sequence of thoughts in trials and the assumption of new ideas. He was the first to describe the paradigm shift, and he clarified the sequence elegantly”.

Khun in his book “The Structure of Scientific Revolutions” should be read by anyone doing new work in science or medicine. It usually takes 20 years or more to develop and accept a new paradigm (which for Theoretical Physicist Kuhn himself these paradigms “are bad” and put blinders on people’s vision) and this time lag occurs while we wait for the old guard, for whom new ideas are anathema, to retire or die. The younger generation accepts the new paradigm as deeper and more acceptable than the old system of thought. But the better the new idea, the longer it takes for it to be accepted.

In the same vein with Michael Foucault with Words and Things, David Hume in Inquiry Concerning Human Knowledge or the one who would give a firm foundation on the philosophy of science in Logik der Forschung, The Logic of Scientific Inquiry without leaving the author of the Black Swan Nassim Nicholas Taleb.With kind Regards.

May 9, 2022 09:05 PM

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