Effectiveness of peripheral neurectomy in refractory cases of trigeminal neuralgia

Lamichhane, Narayan Sharma; Du, Xiaohui; Li, Shanchang; Poudel, Dhruba Chandra

doi:10.4103/0975-8844.195908

Cited by 4 publications

(5 citation statements)

References 2 publications

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“…Lamichhane et al reported the same complications. [8] Other complications reported in the literature included weakness of masseter muscles and very rarely, loss of the corneal reflex. In comparison with other peripheral procedures for TN, alcohol injection can cause local edema, dysesthesia, and necrosis with the surrounding tissues with a risk of pain recurrence.…”

Section: Discussionmentioning

confidence: 99%

“…[7] Peripheral neurectomy is a simple, low-risk procedure that involves surgical avulsion of the postganglionic part of the trigeminal nerve divisions, usually performed under local anesthesia for managing peripheral pain in TN. [8] Despite it is one of the oldest surgical procedures for TN, none of the previous studies about peripheral neurectomy for treatment of TN had been subjected to good statistical analysis. [7] This study aims to evaluate the clinical outcome and the recurrence rate following peripheral neurectomy for the management of TN.…”

Section: Introductionmentioning

confidence: 99%

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

Nagy

Mahmoud

2021

Asian J Neurosurg

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Background: Surgical intervention for trigeminal neuralgia (TN) is indicated if there is a failure of the medical treatment. Peripheral neurectomy is one of the oldest surgical procedures for TN. Objective: The aim is to evaluate the clinical outcome and the recurrence rate following peripheral neurectomy for the management of TN. Patients and Methods: This was a retrospective cohort study of 17 patients with classical TN treated by peripheral neurectomy. The visual analogue scale (VAS) was used for pain assessment preoperatively and during the follow-up period. The outcome of surgery was graded as a marked, moderate, or mild improvement. Kaplan–Meier analysis was used for the time to recurrence to predict the probability of recurrence at any given time following the procedure. Results: The mean pain-free interval was 29.3 ± 16.3 months. At 2 and 5 years of the follow-up period, the mean VAS improved significantly ( P < 0.001 and P = 0.042 respectively). Thirteen patients had marked improvement of pain. There was recurrence of pain in 4 patients (23.5%). By Kaplan–Meier analysis, the survival rate without recurrence at 2, 3, 4, and 5 years following the procedure were 92.9%, 79.6%, 59.7%, and 29.8%, respectively. The mean preoperative Hospital Anxiety and Depression Scale-Anxiety and Depression scores significantly improved on the last follow-up visit following the procedure ( P < 0.001 for both). Conclusion: Peripheral neurectomy provides short to medium-term good pain control for patients with TN. The preoperative severity of pain, anxiety, and depression levels improved markedly after the procedure.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Nagy

Mahmoud

2021

Asian J Neurosurg

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“…Attempts have been made to prevent pain recurrence and nerve regeneration via obliteration of the exiting nerve’s bony foramen, or where nerves are sectioned. 280 Materials that have been used include steel screws, bone, bone wax, silver plugs, or fat. Despite these efforts, a large number of patients experience pain recurrence over 12–24 months.…”

Section: Open Surgerymentioning

confidence: 99%

“…Peripheral neurectomy involves the surgical disconnection of peripheral branches of the trigeminal nerve. [276][277][278][279][280][281][282][283] The procedure is usually performed as an outpatient procedure for patients who have failed medical therapy, or those who have severe medical comorbidities and are unable to tolerate a suboccipital craniectomy for microvascular decompression. The procedure is relatively low cost and does not require extensive surgical, anesthetic, or technological infrastructure, although the outcomes are inferior to MVD.…”

Section: Peripheral Neurectomymentioning

confidence: 99%

“…The procedure has been reported for the supraorbital, supratrochlear, infratrochlear, lacrimal nerves, infraorbital nerve, inferior alveolar, lingual, and mental nerves. [278][279][280] By definition, peripheral neurectomy completely divides the nerve, and so dense numbness along the distribution of the ablated nerve is inevitable and expected.…”

Section: Peripheral Neurectomymentioning

confidence: 99%

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