Neurectomy of the trigeminal nerve branches: clinical evaluation of an "obsolete" treatment.

INTRODUCTION

After all options of conservative treatment of trigeminal neuralgia have been exhausted, surgical methods are used. Peripheral neurectomy is one of the simplest among them. It is a relatively obsolete method, but can still be useful and effective.

AIMS: To analyse the remission period after repetitive neuroexeresis of the same neural branch, to calculate "predicted" remission, and to evaluate the benefits of repetitive neuroexeresis.

PATIENTS AND

METHODS

Total of 85 neurectomies were performed in 36 patients in 5 years by intraoral access. The recurrence time was analysed by simple regression analysis, using the method of the least-squares. Thus, the average pain free time after repetitive neurectomy can be predicted.

RESULTS

After the first operation on the infraorbital nerve, recurrence mainly appeared in the period between 12 and 15 months, after the second between 9 and 12 months. After the first operation on the mandibular nerve, recurrence took place mainly after 15-18 months, after the second 12.3 months on the average. No interventions were performed on the first branch. Calculated prediction of the average time of remission was in agreement with the actual duration of painlessness.

CONCLUSION

Remission time after repetitive neurectomy decreases. There is no point in repeating the surgery on the same neural branch more than three times.