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


OBJECTIVE
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.


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.


CONCLUSIONS
Remission time after repetitive neurectomy decreases. There is no point in repeating the surgery on the same neural branch more than three times.
Cerovic
Robert
R
Clinical Hospital Centre Rijeka, Faculty of Medicine Rijeka, Department of Maxillofacial and Oral surgery, Tome Strizica 3, 51000 Rijeka, Croatia. robert.cerovic@ri.t-com.hr
Juretic
Mirna
M
Gobic
Margita Belusic
MB
D000368:Aged; D003714:Denervation / Q000379:methods*; D005157:Facial Pain / Q000209:etiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008340:Mandibular Nerve / Q000503:physiopathology / Q000601:surgery; D008442:Maxillary Nerve / Q000503:physiopathology / Q000601:surgery; D008875:Middle Aged; D012008:Recurrence; D012074:Remission Induction; D012086:Reoperation; D013997:Time Factors; D017211:Treatment Failure; D014276:Trigeminal Nerve / Q000503:physiopathology / Q000601:surgery*; D014277:Trigeminal Neuralgia / Q000150:complications / Q000601:surgery*