Management of trigeminal neuralgia by peripheral neurectomy

Peripheral neurectomy(PN)is a minimally invasive procedure, for the management of trigeminal neuralgi (TN)consisting of surgical avulsion of terminal branches of the trigeminal nerve. To assess the efficacy of PN in the treatment of refractory TN and their recurrences in a follow up of 18 months. Retro-prospective and prospective study was conducted on randomly selected 30 TN patients irrespective of age, gender and socio-economic status. The branch of trigeminal nerve involved was identified according to the site of pain. Then the PN procedure was performed under local or general aesthesia. The follow up of each patient was done for next 18 months. Mean age of the TN patients 53.17 ± 13.84 years, with 66.7% of patients were within 60 years of age. Male to female ratio was 1:1.5. All patients showed unilateral TN. Mostly 26.7% trigger point was located in lower lip followed by 13.3% in upper lip. After 3,6 and 9 months follow-up, none of the TN patients treated with PN had pain and none had any effect on general activity. However, from 12 months till 18 months' follow up, 2 (6.7%) patients reported of pain. PNs are viable treatment alternative for TN, although peripheral neurectomy has chances of reoccurrence but still offer better quality of life in patients for many years without relaps.