Peter J. Jannetta [Neurosurgery Wiki]

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====== Peter J. Jannetta ======

Peter Joseph Jannetta (April 5, 1932 – April 11, 2016) was an American [[neurosurgeon]] known for devising [[microvascular decompression]].

At the University of [[Pittsburgh]] School of Medicine, he was the first [[Walter Edward Dandy]] Professor of Neurological Surgery.

Born in [[Philadelphia]], Jannetta graduated from the University of [[Pennsylvania]] with an undergraduate degree and a medical degree. He stayed at Penn for training as a general surgeon, then completed a National Institutes of Health fellowship in neurophysiology before training as a neurosurgeon at the University of [[California]], [[Los Angeles]].

During his residency at [[UCLA]], Jannetta was in the [[laboratory]] dissecting a set of [[cranial nerve]]s when he noticed that a blood vessel was unexpectedly pressing on one of the nerves. Jannetta suspected that this abnormal impingement of the nerve might be the cause of the painful facial condition known as [[trigeminal neuralgia]]. 

Peter J. Jannetta proposed the neurovascular compression (NVC) theory in [[1967]]
((Jannetta PJ: Arterial compression of the trigeminal nerve at
the pons in patients with trigeminal neuralgia. J Neurosurg
26:159–162, 1967)).

He, together with his mentor Robert W. Rand, had been developing a technique of selective partial sensory rhizotomy for the treatment of trigeminal neuralgia (TN) and building on the pioneering works of Dandy, Gardner, and others
((Kaufmann AM, Price AV: A Pioneer of the Modern
Microvascular Decompression Surgery: Peter Jannetta.
Rolling Meadows, IL: AANS, 2017 (http://www.aans.org/-/
media/Files/AANS/Media/PDFs/Jannetta_Pioneer-ofModern-MVD-Surgey.ashx?la=en&hash=D112CA68988B
FECE916C28498FD75341369BCBA4) [Accessed April 27,
2018])).

With the assistance of John F. Alksne, the first of these operations was performed through a subtemporal-transtentorial approach and with the novel use of an operating microscope. As exposure was gained, Jannetta revealed the [[superior cerebellar artery]] impinging on the proximal [[trigeminal nerve]] root and quietly exclaimed, “That’s the cause of trigeminal neuralgia.” Similar observations were evident in the next four such rhizotomy surgeries, although Jannetta found no similar compression in a series of cadaveric dissections. Later that same year in the neurosurgery clinic, Jannetta was assessing a gentleman with
hemifacial spasm (HFS) and had an epiphany: this was another cranial nerve hyperexcitability condition analogous to TN and was also likely caused by pulsatile compression upon the proximal cranial nerve root. He explained this to the patient who then consented to what would become Jannetta’s first microvascular decompression (MVD) surgery. Together with his co-surgeon Paul H. Crandall, he identified and alleviated NVC of the facial nerve root exit and achieved a cure of the HFS. Two months later Janneta and Rand performed their first MVD for TN with equal success. The neurosurgery community, however, was slow
to accept this new cure for an old disease. Jannetta persevered despite the naysayers, the critics, and those who questioned his credibility. He gradually presented a body of surgical and clinical follow-up evidence that convinced a critical mass of adopters that MVD was an effective treatment, and neurosurgeons worldwide began to replicate his excellent results
((Kaufmann AM. Editorial. Considering a neurovascular compression etiology. J
Neurosurg. 2018 Jul 20:1-3. doi: 10.3171/2018.3.JNS18385. [Epub ahead of print]
PubMed PMID: 30028265.
)).

----

In addition to helping trigeminal neuralgia patients, the procedure became a treatment option for several related conditions.

He was a faculty member and division chief at [[Louisiana]] State University before moving to a similar role with the University of Pittsburgh in 1971. In 1995, he spent a year as Secretary of Health for the Commonwealth of Pennsylvania. 

Jannetta practiced at Allegheny General Hospital for a few years before he retired.

Jannetta received a Horatio Alger Award in 1990.

The Karolinska Institute honored him with the Herbert Olivecrona Award in 1983.

He was married twice, first to history professor Ann Bowman Jannetta, then to art critic Diana Rose Jannetta.

Jannetta was nominated by Pennsylvania Governor Tom Ridge to be the State Secretary of Health. Jannetta had previously been accused of committing perjury, with the State's Superior Court stating, "We have little difficulty in concluding that Dr. Jannetta's testimony at deposition was different than, or inconsistent with, the testimony at trial". Jannetta was not, however, ever convicted of perjury. Jannetta served in the position for six months, from 1995-96.