Peripheral Neurectomy: A Surgical Option for Trigeminal Neuralgia Involving Inferior Alveolar Nerve

Trigeminal neuralgia is a chronic pain condition affecting one or more distributions of the trigeminal nerve. Patients with this condition experience short, sharp, shooting pain attacks, which can progress to longer, more frequent durations. The pain is often difficult to control. We report of a man who was admitted with severe neuralgia of the third division of the trigeminal nerve. Talking and any oral intake triggered a severe agonising pain. The latter made the regular oral intake of analgesia challenging. The pain was temporarily controlled with frequent local anaesthesia (LA). Dental core trainees were performing regular inferior alveolar nerve blocks which significantly improved patients’ condition allowing him to communicate and have oral intake. Subsequently, a catheter was placed allowing for a continuous anaesthesia. The connecting tube of the cannula was then used by nursing staff to administer LA providing pain relief without the need of repeated intraoral injections.

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Coronectomy: A Surgical Option for Impacted Third Molars in Close Proximity to the Inferior Alveolar Nerve—A 5-Year Follow-Up Study

Journal of Oral and Maxillofacial Surgery ◽

10.1016/j.joms.2018.12.017 ◽

2019 ◽

Vol 77 (6) ◽

pp. 1116-1124 ◽

Cited By ~ 4

Author(s):

Giuseppe Monaco ◽

Mattia D'Ambrosio ◽

Giselle De Santis ◽

Elisabetta Vignudelli ◽

Maria Rosaria Antonella Gatto ◽

...

Keyword(s):

Inferior Alveolar Nerve ◽

Third Molars ◽

Follow Up Study ◽

Close Proximity ◽

Surgical Option

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Effectiveness of peripheral neurectomy in refractory cases of trigeminal neuralgia

Journal of Orofacial Sciences ◽

10.4103/0975-8844.195908 ◽

2016 ◽

Vol 8 (2) ◽

pp. 86 ◽

Cited By ~ 1

Author(s):

NarayanSharma Lamichhane ◽

Xiaoyan Du ◽

Shanchang Li ◽

DhrubaChandra Poudel

Keyword(s):

Trigeminal Neuralgia ◽

Peripheral Neurectomy

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Peripheral neurectomy for trigeminal neuralgia: A report of seventeen cases and review of the literature

Asian Journal of Neurosurgery ◽

10.4103/ajns.ajns_361_20 ◽

2021 ◽

Vol 16 (2) ◽

pp. 281

Author(s):

MohamedRagab Nagy ◽

Bokhary Mahmoud

Keyword(s):

Trigeminal Neuralgia ◽

Review Of The Literature ◽

Peripheral Neurectomy

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Secondary Trigeminal Neuralgia (Balloon Compression Rhizolysis)

Pain Neurosurgery ◽

10.1093/med/9780190887674.003.0003 ◽

2019 ◽

pp. 13-22

Author(s):

Jeffrey A. Brown

Keyword(s):

Multiple Sclerosis ◽

Neuropathic Pain ◽

Trigeminal Neuralgia ◽

Success Rate ◽

Microvascular Decompression ◽

Trigeminal Neuropathic Pain ◽

Simple Treatment ◽

Balloon Compression ◽

One Year ◽

Surgical Option

Multiple sclerosis is a common secondary cause of trigeminal neuropathic pain. It occurs because of the presence of sclerotic plaque within the highly myelinated trigeminal pathway. Patients with multiple sclerosis (MS) may also have a vascular compressive etiology; however, the two-year success rate for microvascular decompression is merely 15%. Ablative treatment also has a high pain recurrence rate that is as high as 50% in one year regardless of the surgical option selected. Balloon compression rhizotomy is a simple treatment option in MS patients. When done, the balloon compression site is at the retrogasserian portion of the trigeminal nerve and not the trigeminal ganglion. Balloon compression is associated with a trigeminal depressor response for which one must be prepared to treat with iv atropine.

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Are peripheral neurectomies of value in the treatment of trigeminal neuralgia? An analysis of new cases and cases involving previous radiofrequency gasserian thermocoagulation

Journal of Neurosurgery ◽

10.3171/jns.1996.85.3.0435 ◽

1996 ◽

Vol 85 (3) ◽

pp. 435-437 ◽

Cited By ~ 30

Author(s):

Raj Murali ◽

Richard L. Rovit

Keyword(s):

Trigeminal Neuralgia ◽

Elderly Patients ◽

Excellent Result ◽

Safe Procedure ◽

Content Type ◽

Limited Life ◽

Experienced Pain ◽

Good Pain Relief ◽

Peripheral Neurectomy ◽

Fine Print

✓ The indications, advantages, complications, and benefits of peripheral neurectomy in patients with trigeminal neuralgia were studied in detail in 40 patients treated between 1982 and 1991. Twenty-eight patients had previously received radiofrequency thermocoagulation; peripheral neurectomy was performed for pain recurrence. These patients had excellent or good pain relief for at least 5 years postsurgery. Of the 12 patients who had peripheral neurectomy as their only procedure, seven had an excellent result and five had a good result. Five of the patients had recurrence of pain after 2 years but responded well to a second neurectomy. Elderly patients who experienced pain in the first and second divisions of the trigeminal distributions were the best candidates. Peripheral neurectomy is an effective, safe procedure for elderly patients who suffer from trigeminal neuralgia and have a limited life span.

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