Ultrasound-Guided Mandibular Nerve Pulsed Radiofrequency With Adjunct Dexamethasone in Trigeminal Neuralgia: A Retrospective Cohort Study.

BACKGROUND

This study aimed to evaluate the clinical outcomes and safety of ultrasound-guided pulsed radiofrequency (PRF) targeting the mandibular nerve (V3) with adjunct low-dose perineural dexamethasone in patients with trigeminal neuralgia (TN).

METHODS

We retrospectively analyzed 73 consecutive patients treated between April 2022 and August 2025. The primary outcome was the change in Numeric Rating Scale (NRS) pain scores at 1, 3, and 6 months. Secondary outcomes included functional status assessed by the Short Form-12 Health Survey (SF-12), adverse events, and reintervention rates.

RESULTS

The mean NRS decreased from 6.97±0.73 at baseline to 2.22±0.80, 3.07±0.82, and 3.30±1.08 at 1, 3, and 6 months, respectively (all P<0.001). SF-12 scores improved significantly at all time points (P<0.001). The minimal clinically important difference (≥2-point reduction) was achieved in more than 90% of patients. Two patients (2.74%) developed minor hematomas, and no major complications were observed. Reintervention was required in 5.48% of patients.

CONCLUSIONS

Ultrasound-guided V3 PRF with adjunct dexamethasone was associated with significant pain reduction and functional improvement, with a favorable safety profile. These findings are observational and require confirmation in controlled prospective studies.