Peripheral Neurectomy: A Minimally Invasive Treatment for Trigeminal Neuralgia. A Retrospective Study

Abstract

Aim Investigate the efficacy of peripheral neurectomy as a surgical procedure in the treatment of trigeminal neuralgia and to evaluate the results obtained by this procedure and their recurrences in a period of three years followup. Materials and Methods Thirty patients were retrospectively reviewed who underwent peripheral neurectomy. The factors analyzed were the demographic details of the patients, side of involvement, branch of nerve involved and procedure used postoperative complications, prognosis and any additional procedure used in cases of recurrences. Results The mean age of the patient was 57.1 years (range 35-71 years) more were males (M:F = 1.73:1) and the surgical treatment was peripheral neurectomy of the involved branch following failure of carbamazepine therapy. There was no intra operative and postoperative complications noted and follow up over 3 years revealed only two cases (6.66%) of recurrence. Two patients were lost to followup, total number evaluated between 0 and 3 years after treatment was 28 patients. Conclusion Peripheral neurectomy is one of the oldest, minimal invasive forms of surgery, well tolerated by the patient and can be done under local anesthesia.

Endoscopic tympanic neurectomy for otic neuralgia—a case series

“…In other areas, a regional neurectomy has been shown to reduce the incidence of neuropathic pain. Examples of this treatment include ilioinguinal neurectomy following chronic neuropathic pain after herniorrhaphy (15)(16)(17) as well as trigeminal neurectomy for trigeminal neuralgia (18). It is proposed that likely an infectious or traumatic insult to the tympanic nerve during middle ear infections can result in the same cascade of neuronal events seen in PHN, with the subsequent division of the nerve removing this perception of otalgia.…”

Obliterating foramina following peripheral neurectomies can prolong remission of neuralgia up to 10 years

“…24 There have been some revivals in the last 5 years as more oral surgeons in the Indian subcontinent reported their use for treating patients who were living in the rural area and were deprived socio-economically of modern neurosurgical facilities. 7,25,40,41 Proponents of peripheral neurectomy think that this procedure still has a role to play with the elderly, medically compromised patients or those not keen to be subjected to extensive neurosurgery. 18,24,39 The surgical techniques employed in this case were essentially the same as described by Hong-Sai.…”

Supraorbital Neuralgia: Sebuah Laporan Kasus

“…11 Neurektomi perifer merupakan tindakan pembedahan yang paling simpel, aman, dan minim efek samping. 1,12 Pada salah satu studi retrospektif pada 28 pasien TN yang dilakukan neurektomi perifer, 2 (6,66%) pasien yang mengalami kekambuhan setelah 1 tahun, sedangkan 26 pasien masih bebas nyeri setalah 3 tahun pasca pembedahan. 12 Komplikasi yang pernah dilaporkan setelah tindakan neurektomi perifer antara lain hemoragi lokal, diplopia transien, rasa tebal atau anestesia pada kulit yang dipersarafi saraf supraorbital, dimana berlangsung hanya untuk beberapa hari.…”

“…1,12 Pada salah satu studi retrospektif pada 28 pasien TN yang dilakukan neurektomi perifer, 2 (6,66%) pasien yang mengalami kekambuhan setelah 1 tahun, sedangkan 26 pasien masih bebas nyeri setalah 3 tahun pasca pembedahan. 12 Komplikasi yang pernah dilaporkan setelah tindakan neurektomi perifer antara lain hemoragi lokal, diplopia transien, rasa tebal atau anestesia pada kulit yang dipersarafi saraf supraorbital, dimana berlangsung hanya untuk beberapa hari. 1 Komplikasi ini lebih ringan dibanding injeksi alkohol dimana dapat terjadi resiko tinggi kekambuhan dan nekrosis jaringan sekitar.…”