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Category: Volume 07 Issue 06 June 2019
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Title: Trigeminal Neuralgia: A 10-Year Retrospective Study

Authors: Dr Fahad Ahmad, Dr Palvi Gupta, Dr Jeevan Lata

 DOI: https://dx.doi.org/10.18535/jmscr/v7i6.97

Abstract

Objective: To analyze the average age, sex, side of involvement, most affected branch in trigeminal neuralgia and efficacy of various treatment modalities used in primary centers which are lack in advance neurosurgical facilities.

Method: Patient’s record of our center was reviewed and data of trigeminal neuralgia patients was collected from January 2001 to December 2010.

Results: Total 484 patients of idiopathic trigeminal neuralgia were treated in 10 year period with slight female predominance (52.68%). Right side was involved in 60.95% patients. Most affected branch was inferior alveolar nerve (53.47%). Seasonal variation was also documented. Medicinal treatment, absolute alcohol nerve block and peripheral neurectomy were the treatment used and average pain relief period documented as 23.13 months, 18.40 months and 32.23 months respectively.

Conclusion: We concluded that gradual increase from medicinal to surgical intervention is the best approach to manage facial neuralgia. In primary centers peripheral neurectomies can be considered as the best treatment option which is minimal invasive, and done under LA with predictable results. Moreover it can be performed easily in elder, short life span as well as in unfit patients.

Keywords: Trigeminal Neuralgia; Peripheral neurectomy; Alcohol nerve block; Facial neuralgia.

References

  1. Das B, Saha SP. Trigeminal neuralgia: current concepts & management. J Indian Med Assoc. 2001, 99: 704–709
  2. Cerovic R. Neurectomy of the trigeminal nerve branches: clinical evaluation of an obsolete treatment. J Cranio-Maxillofac Surg. 2009, 37: 388–391
  3. Ginwala MSN. Surgical treatment of trigeminal neuralgia of third division. Oral Surg. 1961, 14: 1300
  4. Loveren V H, TewJM , Keller JT, Nurre MA.A 10-year experience in the treatment of trigeminal neuralgia.Comparison of percutaneous stereotaxic rhizotomy and posterior fossa exploration.J Neurosurg. 1982, 57(6): 757-764
  1. Ong KS, Keng SB. Evaluation of surgical procedures for trigeminal neuralgia. AnesthProg. 2003, 50: 181–188
  2. Liu JK, Apfelbaum RI. Treatment of trigeminal neuralgia. NeurosurgClin N Am. 2004, 15: 319–334
  3. Broggi G, Ferroli P, Franzini A, Galosi L. The role of surgery in the treatment of typical and atypical facial pain. Neurol Sci. 2005, 26: 95–100
  4. Bagheri S, Farhidvash F, Perciaccante V. Diagnosis & treatment of patients with trigeminal neuralgia. J Am Dent Assoc. 2004, 135: 1713–1717
  5. Chole R, Patil R, Degwekar S, Bhowate R. Drug treatment of trigeminal neuralgia: a systemic review of the literature. J Oral Maxillofac Surg. 2007, 65: 40–45
  6. Hassan Salama et al. Outcome of medical and surgical management in intractable idiopathic trigeminal neuralgia. Ann Indian Acad Neurol. 2009, 12(3): 173–178
  7. Al-Khateeb T L. Morphologic effects of glycerol on the mental nerve. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 1998 March, 85(3): 248–251
  8. Grantham EG, Segerberg LH. An evaluation of palliative surgical procedures in trigeminal neuralgia. J Neurosurg. 1952, 9: 390–394
  9. Quinn JH. Repetitive peripheral neurectomies for neuralgia of second and third divisions of trigeminal nerve. J Oral Surg. 1965, 23: 600–608
  10. Khanna JN, Galinde JS. Trigeminal neuralgia Report of 140 cases. Int J Oral Surg. 1985, 14: 325–332
  11. Nurmikko TJ, Eldridge PR. Trigeminal neuralgia- pathophysiology, diagnosis and current treatment. Br J Anesth. 2001, 87(1): 117–132
  12. Toda K. Operative treatment of trigeminal neuralgia: review of current techniques. Oral Surg Oral Med Oral Pathol Oral RadiolEndod. 2008, 106: 788–805
  13. Shah SA, Khattak A, Shah FA, Khan Z. The role of peripheral neurectomies in the treatment of Trigeminal neuralgia in modern practice. Pak Oral Dent J. 2008, 28(2): 237–240
  14. Agrawal SM, Kambalimath DH. Peripheral Neurectomy: A Minimally Invasive Treatment for Trigeminal Neuralgia.A Retrospective Study. J. Maxillofac. Oral Surg. 2011, July-Sept10(3): 195–198
  15. Ebenezer V, Balakrishnan K,  Sivakumar M. Peripheral Neurectomy under Local Anesthesia-Case Report. World Journal of Medical Sciences. 2014, 10(1): 69-73.

Corresponding Author

Dr Fahad Ahmad

MDS, Registrar Surgeon,  Department of Oral & Maxillofacial Surgery, Al-Jahra Specialty Dental Center & Hospital,  Ministry Of Health, Kwt.

Ex-Resident, Punjab Govt. Dental College & Hospital, Amritsar, India