The place of peripheral neurectomy in the management of trigeminal neuralgia

Abstract

Summary One hundred and forty-six patients with trigeminal neuralgia were studied. Of 49 patients ultimately maintained pain-free by non-medical means, 26 underwent peripheral neurectomy. Twenty of these achieved excellent pain control in the longer term and 5 of the remaining 6 became more responsive to carbamazepine after operation. Seven patients required repeat neurectomies. Peripheral neurectomy is a useful and simple method of pain control in trigeminal neuralgia.

Neurectomy of the trigeminal nerve branches: Clinical evaluation of an “obsolete” treatment

“…The painless period after one neurectomy in our patients was 16.3 months on average. Better results were found by Freemont and Millac (1981), who reported the recurrence in their patients after 26.5 months on average, while according to Lazar (1980), the success of neurectomy is rarely longer than a year. Bagatin and Arko (1984) mention a painless period of 12.2 months, and Hong-Sai (1999) of at least 2 years.…”

“…On the contrary, the patients complained of more severe pain in the recurrence period and needed higher doses of carbamazepine. Thus, the side-effects of the drug were more pronounced (Freemont and Millac, 1981;Hong-Sai, 1999). The painless period after one neurectomy in our patients was 16.3 months on average.…”

“…Recurrence happens after 1e2 years, although some authors report painless periods of 3 or 4 years (Mason, 1972;Freemont and Millac, 1981;Bagatin and Arko, 1984). Neurectomy of the same neural branch can be repeated, but with decreasing results i.e., recurrence appears sooner.…”

Tri̇gemi̇nal Nevralji̇

“…Periferal Nöroktomi (PN) PN yaşlı hastalarda ve MVD veya diğer perkütan işlemlerin kontraendike olduğu zamanlarda tercih edilir 71,72 . Freemont ve ark.…”

“…Freemont ve ark. 72 tek bir sinire uygulanan nöroktomi işleminin ortalama 26,5 ay ağrısız bir dönem sunduğunu rapor etmiştir. Murali ve Rovit 71 periferal nöroktomi uyguladıkları 12 hastanın 7 tanesinin tamamıyla ağrılarında rahatlama yaşadığı ve 5 tanesinin ise ağrılarında oldukça azalma olduğunu bildirmiştir.…”