Triple Isomerism in 3D Covalent Organic Frameworks.

Isomerism in covalent organic frameworks (COFs) has scarcely been known. Here, for the first time we show 3D COFs with three framework isomers or polymorphs constructed from the same building blocks. All isomers were obtained as large (>10 µm) crystals; although their crystal shapes were distinctly different, they showed identical FT-IR and solid-state NMR spectra. Our structural analyses revealed unprecedented triple isomerism in 3D COFs (noninterpenetrated dia, qtz, and 3-fold interpenetrated dia-c3 nets). Furthermore, this Communication reports the first known COF with qtz topology for which the structure determination was based on Rietveld analysis. We achieved triple framework isomerism by reticulating a tetrahedral building block with a flexible junction and a linear building block with PEO side chains and by varying solution compositions. Our energy calculations, along with the discovery of interisomer transition, revealed that the isomer with qtz topology was a kinetic isomer. Thus, this simple yet little-explored concept of reticulating only flexible building blocks is an effective pathway to significantly broaden the diversity of 3D COFs, which have been proposed for a myriad of applications.

Phosphonic acid anchored tripodal molecular films on indium tin oxide.

Whereas monopodal self-assembling monolayers (SAMs) are most frequently used for surface and interface engineering, tripodal SAMs are less popular due to the difficulty in achieving a reliable and homogeneous bonding configuration. In this context, in the present study, the potential of phosphonic acid (PA) decorated triptycene (TripPA) for formation of SAMs on oxide substrates was studied, using indium tin oxide (ITO) as a representative and application-relevant test support. A combination of several complementary experimental techniques was applied and a suitable monopodal reference system, benzylphosphonic acid (PPA), was used. The resulting data consistently show that TripPA forms well-defined, densely packed, and nearly contamination-free tripodal SAMs on ITO, with the similar parameters and properties as the monopodal reference system. Modification of wetting properties and work function of ITO by non-substituted and cyano-decorated TripPA SAMs was demonstrated, showing a potential of this tripodal system for surface engineering of oxide substrates.

Anatomical considerations and surgical manipulation of the rhomboid lip in microvascular decompression for hemifacial spasm.

BACKGROUND: In microvascular decompression (MVD) procedures for hemifacial spasm (HFS), surgeons often encounter a rhomboid lip which may obscure the root exit zone (REZ) of the facial nerve. This study aims to explore the anatomical variations of rhomboid lips and their surgical implications to improve safety and effectiveness in MVD surgeries. METHODS: A retrospective analysis was conducted on 111 patients treated for HFS between April 2021 and March 2023. The presence of a rhomboid lip was assessed through operative video records, and its characteristics, dissection methods, and impact on nerve decompression outcomes were further examined. Preoperative magnetic resonance imaging (MRI) scans were reviewed for detectability of the rhomboid lip. RESULTS: Rhomboid lips were identified in 33% of the patients undergoing MVD, with a higher prevalence in females and predominantly on the left side. Two distinct types of rhomboid lips were observed: membranous and cystic variations. The membranous type was noted for its smaller size and position ventral to the choroid plexus. In contrast, the cystic variation was distinguished by its larger size and a thin membrane that envelops the choroid plexus. Preoperative MRI successfully identified rhomboid lips in only 21% of the patients who were later confirmed to have them in the surgical procedures. Surgical approaches primarily involved incisions on the dorsal wall and along the glossopharyngeal nerve root, with only limited need for extensive dissection from lower cranial nerves. Immediate spasm relief was observed in 97% of the patients. One case exhibited a lower cranial nerve deficit accompanied by brainstem infarction, which was caused by the dissection from the lower cranial nerves. CONCLUSIONS: Recognizing the two variations of the rhomboid lip and understanding their anatomical structures are essential for reducing lower cranial nerve injuries and ensuring effective nerve decompression.

Insights into Thermal Transport through Molecular π-Stacking.

π-Stacking, which is a ubiquitous structural motif in assemblies of aromatic compounds, is well-known to provide a transport pathway for charge carriers and excitons, while its contribution to thermal transport is still unclear. Herein, based on detailed experimental observations of the thermal diffusivity, thermal conductivity, and specific heat of a single-crystalline triphenylene featuring a one-dimensionally π-stacked structure, we describe the nature of thermal transport through the π-stacked columns. We reveal that acoustic phonons are responsible for thermal transport through the π-stacked columns, which exhibit crystal-like behavior. Importantly, the thermal energy stored as intramolecular vibrations can also be transported by coupling to the acoustic phonons. In contrast, in the direction perpendicular to the π-stacked columns, an amorphous-like thermal transport behavior dominates. The present finding offers deep insight into nanoscale thermal transport in organic materials, where the constituent molecules exist as discrete entities linked together by weak intermolecular interactions.

Synthesis and Properties of B4 N4 -Heteropentalenes Fused with Polycyclic Hydrocarbons.

Hybrid molecules of π-conjugated carbon rings and BN-heterocyclic rings (h-CBNs) fused with each other have been a rare class of compounds due to the limited availability of their synthetic methods. Here we report the synthesis of new h-CBNs featuring a B4 N4 -heteropentalene core and polycyclic aromatic hydrocarbon wings. Using 1,2-azaborinine derivatives as a building block, we developed a rational synthetic protocol that allows the formation of a B4 N4 ring in a stepwise manner, resulting in the fully fused ABA-type triblock molecules. Thus, three derivatives of 1 bearing naphthalene (1Naph ), anthracene (1Anth ), or phenanthrene (1Phen ) wings fused with the B4 N4 core were synthesized and characterized. Among them, 1Phen , which displays the highest triplet-state energy, was found to serve a host material for phosphorescent OLED devices, for which a maximum external quantum efficiency of 13.7 % was recorded. These findings may promote the synthesis of various types of h-CBNs aiming at new properties arising from the synergy of two different π-electronic systems.

3,11-Diaminodibenzo[a,j]phenazine: Synthesis, Properties, and Applications to Tröger's Base-Forming Ladder Polymerization.

A new class of diamino-substituted π-extended phenazine compound was synthesized, and its photophysical properties were investigated. The U-shaped diaminophenazine displayed photoluminescence in solution with moderate quantum yield. The diamino aromatic compound was found applicable to the poly-condensation with formaldehyde to form Tröger's base ladder polymer. The obtained microporous ladder polymer features high CO2 adsorption selectivity against N2 , most likely due to the presence of basic nitrogen atoms in the phenazine rings.

Inversion of Diaza[5]Helicenes Through an N-N Bond Breaking Pathway.

1,1',10,10'-Biphenothiazine and its S,S,S',S'-tetroxide are diaza[5]helicenes with N-N linkages. Kinetic experiments on racemization together with DFT calculations revealed that they undergo inversion through the N-N bond breaking pathway rather than the general conformational pathway. In these diaza[5]helicenes with this inversion mechanism, the reduction of electronic repulsion in the N-N bond by modification of S to SO2 at the outer position of the helix led to a significantly higher inversion barrier, 35.3 kcal/mol, compared to [5]helicene. 1,1',10,10'-Biphenothiazine S,S,S',S'-tetroxide was highly resistant to acid-mediated N-N bond breaking and racemization under acidic conditions.

Radical resection of intracavernous chondrosarcoma using an intradural keyhole approach: how I do it.

BACKGROUND: Skull base chondrosarcoma is rare, arising from the clivus or petroclival junction, and usually presents as ocular motility disorders. Endonasal transsphenoidal surgery may be performed in some cases of midline clivus chondrosarcoma. Chondrosarcoma is located within the cavernous sinus and presents a softer/gelatinous mass and can be removed with suctions and curettage. We have been using a simple intradural keyhole transcavernous approach, avoiding a complex extradural transcavernous dissection. METHODS: The intracavernous chondrosarcoma was removed via a 5 mm keyhole opening over the Parkinson's triangle using a standard frontotemporal intradural approach. CONCLUSION: Minimally invasive keyhole surgical resection can be performed to eradicate skull base chondrosarcomas, avoiding complex extradural cranial base approaches.

Potential reasons for failure and recurrence in microvascular decompression for hemifacial spasm.

BACKGROUND: To examine the factors contributing to persistent and recurrent hemifacial spasms (HFS) following a microvascular decompression (MVD) procedure and to suggest technical improvements to prevent such failures. METHODS: A retrospective review was conducted on fifty-two cases of repeat surgery. The extent of the previous craniotomy and the location of neurovascular compression (NVC) were investigated. The operative findings were categorized into two groups: "Missing Compression" and "Teflon Contact". The analysis included long-term outcomes and operative complications after repeat MVD procedures. RESULTS: Missing compression was identified in 29 patients (56%), while Teflon contact was observed in 23 patients (44%). Patients with missing compression were more likely to experience improper craniotomy (66%) compared to those with Teflon contact (48%). Medially located NVC was a frequent finding in both groups, mainly due to compression by the anterior inferior cerebellar artery. In the missing compression group, during the repeat MVD, Teflon sling retraction was utilized in 79% of cases, while in the Teflon contact group, the most common procedure involved removing the Teflon in contact (65%). After the repeat MVD procedure, immediate spasm relief was achieved in 42 patients (81%), with six (12%) experiencing delayed relief. After a median follow-up of 54 months, 96% of patients were free from spasms. Delayed facial palsy, facial weakness, and hearing impairment were more frequently observed in the Teflon contact group. CONCLUSIONS: A proper craniotomy that provides adequate exposure around the REZ is crucial to prevent missing the culprit vessel during the initial MVD procedure. Teflon contact on the REZ should be avoided, as it poses a potential risk of procedure failure and recurrence.

Synthesis and Characterization of Side-Chain Liquid-Crystalline Block Copolymers Containing Cyano-Terminated Phenyl Benzoate Moieties.

Block copolymers, known for their capacity to undergo microphase separation, spontaneously yield various periodic nanostructures. These precisely controlled nanostructures have attracted considerable interest due to their potential applications in microfabrication templates, conducting films, filter membranes, and other areas. However, it is crucial to acknowledge that microphase-separated structures typically exhibit random alignment, making alignment control a pivotal factor in functional material development. To address this challenge, researchers have explored the use of block copolymers containing liquid-crystalline (LC) polymers, which offer a promising technique for alignment control. The molecular structure and LC behavior of these polymers significantly impact the morphology and alignment of microphase-separated structures. In this study, we synthesized LC diblock copolymers with cyano-terminated phenyl benzoate moieties and evaluated the microphase-separated structures and molecular alignment behaviors. The LC diblock copolymers with a narrow molecular weight distribution were synthesized by atom transfer radical polymerization. Small angle X-ray scattering measurements revealed that the block copolymers exhibit smectic LC phases and form cylinder structures with a lattice period of about 18 nm by microphase separation. The examination of block copolymer films using polarized optical microscopy and polarized UV-visible absorption spectroscopy corroborated that the LC moieties were uniaxially aligned along the alignment treatment direction.

Photoactuating Artificial Muscles of Motor Amphiphiles as an Extracellular Matrix Mimetic Scaffold for Mesenchymal Stem Cells.

Mimicking the native extracellular matrix (ECM) as a cell culture scaffold has long attracted scientists from the perspective of supramolecular chemistry for potential application in regenerative medicine. However, the development of the next-generation synthetic materials that mimic key aspects of ECM, with hierarchically oriented supramolecular structures, which are simultaneously highly dynamic and responsive to external stimuli, remains a major challenge. Herein, we present supramolecular assemblies formed by motor amphiphiles (MAs), which mimic the structural features of the hydrogel nature of the ECM and additionally show intrinsic dynamic behavior that allow amplifying molecular motions to macroscopic muscle-like actuating functions induced by light. The supramolecular assembly (named artificial muscle) provides an attractive approach for developing responsive ECM mimetic scaffolds for human bone marrow-derived mesenchymal stem cells (hBM-MSCs). Detailed investigations on the photoisomerization by nuclear magnetic resonance and UV-vis absorption spectroscopy, assembled structures by electron microscopy, the photoactuation process, structural order by X-ray diffraction, and cytotoxicity are presented. Artificial muscles of MAs provide fast photoactuation in water based on the hierarchically anisotropic supramolecular structures and show no cytotoxicity. Particularly important, artificial muscles of MAs with adhered hBM-MSCs still can be actuated by external light stimulation, showing their ability to convert light energy into mechanical signals in biocompatible systems. As a proof-of-concept demonstration, these results provide the potential for building photoactuating ECM mimetic scaffolds by artificial muscle-like supramolecular assemblies based on MAs and offer opportunities for signal transduction in future biohybrid systems of cells and MAs.

Capturing the Trajectory of Metal-Ion-Cluster Formation: Stepwise Accumulation of Zn(II) Ions in a Robust Coordination Space Formed by a Rigid Tridentate Carboxylate Ligand.

Organic ligand-directed synthesis of metal-ion clusters with a well-defined number and arrangement of metal ions is an important subject toward the development of functional inorganic-organic nanohybrids. Here we report the synthesis of multinuclear Zn-oxo clusters using a triptycene-based rigid ligand (H3L) featuring three metal-coordination sites arranged in a triangular shape. Upon complexation of H3L with zinc acetate dihydrate, a decanuclear Zn-oxo cluster and multinuclear Zn-oxo clusters with a smaller number of Zn(II) ions were formed as the final product and its intermediates, respectively. A comparison of the X-ray structure of the final product with those of the intermediates revealed the cluster-formation process, where four triptycene ligands preorganize to form a robust coordination space to which Zn(II) ions accumulate in a stepwise manner. This stepwise metal-ion accumulation, along with the formation of a large tetrahedral decanuclear Zn-oxo cluster, highlights the potential of ligand design using 1,8,13-substituted triptycenes for the development of various metal-ion clusters.

Understanding the evolution of the Raman spectra of molecularly p-doped poly(3-hexylthiophene-2,5-diyl): signatures of polarons and bipolarons.

Molecular doping is a key process to increase the density of charge carriers in organic semiconductors. Doping-induced charges in polymer semiconductors result in the formation of polarons and/or bipolarons due to the strong electron-vibron coupling in conjugated organic materials. Identifying the nature of charge carriers in doped polymers is essential to optimize the doping process for applications. In this work, we use Raman spectroscopy to investigate the formation of charge carriers in molecularly doped poly(3-hexylthiophene-2,5-diyl) (P3HT) for increasing dopant concentration, with the organic salt dimesityl borinium tetrakis(penta-fluorophenyl)borate (Mes2B+ [B(C6F5)4]-) and the Lewis acid tris(pentafluorophenyl)borane [B(C6F5)3]. While the Raman signatures of neutral P3HT and singly charged P3HT segments (polarons) are known, the Raman spectra of doubly charged P3HT segments (bipolarons) are not yet sufficiently understood. Combining Raman spectroscopy measurements on doped P3HT thin films with first-principles calculations on oligomer models, we explain the evolution of the Raman spectra from neutral P3HT to increasingly doped P3HT featuring polarons and eventually bipolarons at high doping levels. We identify and explain the origin of the spectral features related to bipolarons by tracing the Raman signature of the symmetric collective vibrations along the polymer backbone, which - compared to neutral P3HT - redshifts for polarons and blueshifts for bipolarons. This is explained by a planarization of the singly charged P3HT segments with polarons and rather high order in thin films, while the doubly charged segments with bipolarons are located in comparably disordered regions of the P3HT film due to the high dopant concentration. Furthermore, we identify additional Raman peaks associated with vibrations in the quinoid doubly charged segments of the polymer. Our results offer the opportunity for readily identifying the nature of charge carriers in molecularly doped P3HT while taking advantage of the simplicity, versatility, and non-destructive nature of Raman spectroscopy.

Indication for a skull base approach in microvascular decompression for hemifacial spasm.

BACKGROUND: A thorough observation of the root exit zone (REZ) and secure transposition of the offending arteries is crucial for a successful microvascular decompression (MVD) for hemifacial spasm (HFS). Decompression procedures are not always feasible in a narrow operative field through a retrosigmoid approach. In such instances, extending the craniectomy laterally is useful in accomplishing the procedure safely. This study aims to introduce the benefits of a skull base approach in MVD for HFS. METHODS: The skull base approach was performed in twenty-eight patients among 335 consecutive MVDs for HFS. The site of the neurovascular compression (NVC), the size of the flocculus, and the location of the sigmoid sinus are measured factors in the imaging studies. The indication for a skull base approach is evaluated and verified retrospectively in comparison with the conventional retrosigmoid approach. Operative outcomes and long-term results were analyzed retrospectively. RESULTS: The extended retrosigmoid approach was used for 27 patients and the retrolabyrinthine presigmoid approach was used in one patient. The measurement value including the site of NVC, the size of the flocculus, and the location of the sigmoid sinus represents well the indication of the skull base approach, which is significantly different from the conventional retrosigmoid approach. The skull base approach is useful for patients with medially located NVC, a large flocculus, or repeat MVD cases. The long-term result demonstrated favorable outcomes in patients with the skull base approach applied. CONCLUSIONS: Preoperative evaluation for lateral expansion of the craniectomy contributes to a safe and secure MVD.

Factors affecting global neurocognitive status and frontal executive functions in the early stage after surgical clipping of unruptured anterior circulation aneurysms with respect to keyhole clipping and conventional clipping.

PURPOSE: This study investigated the most significant factor for the preservation of the global neurocognitive status and frontal executive functions in the surgical clipping of unruptured anterior circulation aneurysms, specifically in keyhole and conventional clipping procedures. METHODS: The prospective study that was performed to examine the effects of aneurysm surgery on the patient's global neurocognitive status and frontal executive functions started on April 2016. After exclusion posterior circulation aneurysms, anterior communicating aneurysms treated by interhemispheric approach, giant aneurysms, and paraclinoid aneurysms, 23 patients who were enrolled before May 2017 were treated by conventional clipping, and 18 patients who were enrolled after June 2017 were treated by keyhole clipping. Two patients were excluded from each group due to missing data. Finally, 21 and 16 patients in each group were analyzed, respectively. Three-tesla magnetic resonance imaging was performed before and after surgery to detect the presence of perioperative cerebral infarctions and brain edema. The Mini-Mental State Examination, Frontal Assessment Battery, and Self-Rating Depression Scale scores were obtained before and 1 month after surgery. RESULTS: Logistic regression analyses indicated that anterior communicating and internal carotid artery aneurysms were the most significant factors for poor outcomes and that keyhole clipping for these two types of aneurysm was the most significant factor for the preservation of patient global neurocognitive status. Keyhole clipping was also the most significant factor for the preservation of frontal executive functions in patients. CONCLUSIONS: Keyhole clipping may be more favorable than conventional clipping for the preservation of the global neurocognitive status and frontal executive functions. Moreover, it may be the most effective factor for preservation of global neurocognitive status when it is indicated for anterior communicating or internal carotid artery aneurysms.

Tetraaryldiborane(4) Can Emit Dual Fluorescence Responding to the Structural Change around the B-B Bond.

We report the successful synthesis of tetramesityldiborane(4) (Mes4 B2 ) through the reductive coupling of a dimesitylborinium ion. Owing to the steric protection conferred by the mesityl groups, Mes4 B2 shows exceptional chemical stability and remains intact in water. Single-crystal X-ray analysis revealed that Mes4 B2 has an orthogonal geometry, where the B-B center is completely hidden by the mesityl groups. Remarkably, Mes4 B2 emits dual fluorescence at 460 and 620 nm, both in solution and in the solid state. Theoretical calculations showed that Mes4 B2 in the excited S1 state adopts a twisted or planar geometry, which is responsible for the shorter- or longer-wavelength fluorescence, respectively. The intensity ratio of the dual fluorescence is sensitive to the viscosity of the medium, which suggests that Mes4 B2 has potential as a ratiometric viscosity sensor.

Visualization of Thermal Transport Properties of Self-Assembled Monolayers on Au(111) by Contact and Noncontact Scanning Thermal Microscopy.

Thermal transport properties of patterned binary self-assembled monolayers (SAMs) on Au(111) were examined using scanning thermal microscopy (SThM) with both contact and noncontact methods. We fabricated two-dimensional (2D) patterns with two separate domains of n-hexadecanethiol/benzenethiol, benzenethiol/n-butanethiol, or n-hexadecanethiol/n-butanethiol. In the experimental setup, the efficiency of thermal transport from a SThM tip to the SAM surface can be evaluated in terms of the temperature change at the SThM tip. In the contact regime, where a SThM tip physically contacts the SAM surface, direct thermal transport through the SAM and radiation-based thermal transport through the space where SAMs exist may contribute to a drop in temperature at the tip. In the noncontact regime, thermal transport relies on radiation-based heat dissipation from the heated tip to the SAMs. 2D mapping of the spatial temperature distribution on SAMs reflects the difference in thermal transport properties of the two SAM domains. We found that the contact method is effective for visualizing the temperature contrast, which reflects the thermal transport properties of the constituent molecules when the domains of the SAMs have a similar height, while the noncontact method allows visualization of the temperature distribution, which is related to the height of each domain of the SAMs, rather than the chemical structures of the constituent molecules. Combination of contact and noncontact SThM enables 2D imaging of thermal transport properties and topographic imaging simultaneously and represents a new technique for investigating the thermal properties of materials surfaces, which is essential for nanoscale thermal management.

Location of the abducens nerve stretched by a tortuous vertebrobasilar artery in trigeminal neuralgia.

BACKGROUND: Trigeminal neuralgia (TGN) caused by the vertebrobasilar artery (VBA) is uncommon. The abducens nerve root is frequently dislocated by a tortuous VBA near the trigeminal nerve root. This unusual location of the root is not well known. This study aimed to investigate the location of the stretched abducens nerve root. METHODS: The objective is 26 patients with VBA-related TGN who underwent microvascular decompression (MVD). We retrospectively investigated the course of the abducens nerve root with magnetic resonance imaging (MRI) with three-dimensional (3D) imaging and surgical findings. The displacement of the abducens nerve root on the affected side was compared to the contralateral side. RESULTS: The abducens nerve root was distorted by a tortuous VBA (46.2%) or the anterior inferior cerebellar artery (53.8%). The average length of the cisternal segment was stretched to 23.4 mm versus 12.4 mm on the contralateral side. The peak point of the elevated abducens nerve root was mostly located rostro-medial (65.4%) or caudo-medial (34.6%) to the neurovascular compression site of the trigeminal nerve with a mean distance of 9.1 mm. Contact with the trigeminal nerve root was observed in 7 patients (26.9%). Three-dimensional imaging was consistent with the surgical findings and useful in predicting the location of the abducens nerve root. No abducens nerve palsy was noted in our series. CONCLUSIONS: The abducens nerve root is located near the trigeminal nerve root in VBA-related TGN. Preoperative understanding of the unusual course of the abducens nerve root contributes to avoiding accidental nerve injury during MVD.

Neurosurgical management of petrous bone lesions: classification system and selection of surgical approaches.

BACKGROUND: Surgery of petrous bone lesions (PBLs) is challenging for neurosurgeons. Selection of the surgical approach is an important key for success. In this study, the authors present an anatomical classification for PBLs that has been used by our group for over the past 26 years. The objective of this study is to investigate the benefits and applicability of this classification. METHODS: Between 1994 and 2019, 117 patients treated for PBLs were retrospectively reviewed. Using the V3 and arcuate eminence as reference points, the petrous bone is segmented into 3 parts: petrous apex, rhomboid, and posterior. The pathological diagnoses, selection of the operative approach, and the extent of resection (EOR) were analyzed and correlated using this classification. RESULTS: This series included 22 facial nerve schwannomas (18.8%), 22 cholesterol granulomas (18.8%), 39 chordomas/chondrosarcomas (33.3%), 6 trigeminal schwannomas (5.1%), 13 epidermoids/dermoids (11.1%), and 15 other pathologies (12.8%). PBLs were most often involved with the petrous apex and rhomboid areas (46.2%). The extradural subtemporal approach (ESTA) was most frequently used (57.3%). Gross total resection was achieved in 58.4%. Symptomatic improvement occurred in 92 patients (78.6%). Our results demonstrated a correlation between this classification with each type of pathology (p < .001), selection of surgical approaches (p < 0.001), and EOR (p = 0.008). Chordoma/chondrosarcoma, redo operations, and lesions located medially were less likely to have total resection. Temporary complications occurred in 8 cases (6.8%), persistent morbidity in 5 cases (4.3%), and mortality in 1 case. CONCLUSION: In this study, we proposed a simple classification of PBLs. Using landmarks on the superior petrosal surface, the petrous bone is divided into 3 parts, apex, rhomboid, and posterior. Our results demonstrated that chordoma/chondrosarcoma, redo operations, and lesions involving the tip of the petrous apex or far medial locations were more difficult to achieve total resection. This classification could help surgeons understand surgical anatomy framework, predict possible structures at risk, and select the most appropriate approach for each patient.

Microvascular decompression for trigeminal neuralgia attributable to the vertebrobasilar artery: decompression technique and significance of separation from the nerve root.

BACKGROUND: Separation of the vertebrobasilar artery (VBA) from the trigeminal nerve root in microvascular decompression (MVD) is technically challenging. This study aimed to review the clinical features of VBA involvement in trigeminal neuralgia and evaluate surgical decompression techniques in the long term. METHODS: We retrospectively reviewed the surgical outcomes of 26 patients (4.4%) with VBA involvement in 585 consecutive MVDs for TGN using a Teflon roll for repositioning the VBA. The final operative status of the nerve decompression was categorized into two groups: the separation group and the contact group. Separation of the VBA from the nerve root was completed in 13 patients in the separation group, and slight vascular contact remained in the remaining 13 patients of the contact group. The clinical features of VBA-related TGN were investigated and the operative results were analyzed. RESULTS: Multiple arteries are involved in neurovascular compression (NVC) in most cases. The anterior inferior cerebellar artery was the most common concomitant artery (69%). The site of the NVC varies from the root entry zone to the distal portion of the root. All patients were pain-free immediately after surgery and maintained medication-free status during the follow-up period, except for one patient (3.8%) who had recurrent facial pain 8 years after surgery. Postoperative facial numbness was observed in six patients (23%). Of these, one patient showed improvement within 3 months and the other five patients had persistent facial numbness (19.2%). Other neurological deficits include one dry eye, one diplopia due to trochlear nerve palsy, two decreased hearing (< 50 db), two facial weaknesses, and two cerebellar ataxia. Although most of them were transient, one dry eye, two hearing impairments, and one cerebellar ataxia became persistent deficits. Statistical analyses revealed no difference in surgical efficacy or complications in the long term between the two groups. CONCLUSIONS: Slightly remaining vascular contact does not affect pain relief in the long term. Our study indicated that once the tense trigeminal nerve is loosened, further attempts to mobilize the VBA are not necessary.