title: Treatment of a subtype of trigeminal neuralgia with descending palatine neurotomy in the pterygopalatine fossa via the greater palatine foramen-pterygopalatine canal approach.
abstract: OBJECTIVE
  To discuss an effective surgical treatment of a subtype of trigeminal neuralgia with descending palatine neuralgia of the maxillary division.
  
  
  METHODS
  Nine patients, who suffered from trigeminal neuralgia with descending palatine neuralgia of the maxillary division, received neurotomy and avulsion of the descending palatine nerve in the pterygopalatine fossa via the greater palatine foramen-pterygopalatine canal approach. Seven of the patients had a recurrence of descending palatine neuralgia after they received treatment of maxillary neuralgia with neurotomy and avulsion of the infraorbital nerve; two patients were diagnosed with descending palatine neuralgia of the maxillary division in our department. Postoperative follow-up was conducted.
  
  
  RESULTS
  Pain in the palate disappeared; all patients felt numb and paresthetic in the area innervated by the trigeminal nerve, with no pain. During the 3-36 months of follow-up, no recurrence occurred.
  
  
  CONCLUSIONS
  Descending palatine neurotomy in the pterygopalatine fossa via the greater palatine foramen-pterygopalatine canal approach is a simple, safe and effective way to treat a subtype of trigeminal neuralgia--descending palatine neuralgia.
authors.affiliation: Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China. Electronic address: 26084789@qq.com.
authors.forename: Junbing
authors.initials: J
authors.lastname: Guo
authors.affiliation: Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China. Electronic address: daiyin250@sohu.com.
authors.forename: Daiyin
authors.initials: D
authors.lastname: Huang
authors.affiliation: Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China. Electronic address: chensongling@hotmail.com.
authors.forename: Songling
authors.initials: S
authors.lastname: Chen
authors.affiliation: Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China. Electronic address: surgergman@sohu.com.
authors.forename: Shuangxi
authors.initials: S
authors.lastname: Zhu
authors.affiliation: Department of Prosthetic Dentistry, The First People's Hospital of Yunnan, Kunming, China. Electronic address: 476357411@qq.com.
authors.forename: Qiong
authors.initials: Q
authors.lastname: Rong
mesh_terms: D000328:Adult; D000368:Aged; D003389:Cranial Nerve Diseases / Q000601:surgery; D004564:Electrocoagulation / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008442:Maxillary Nerve / Q000601:surgery; D008443:Maxillary Sinus / Q000601:surgery; D008875:Middle Aged; D009437:Neuralgia / Q000601:surgery; D019635:Neurosurgical Procedures / Q000379:methods; D009915:Orbit / Q000294:innervation; D010027:Osteotomy / Q000295:instrumentation; D010159:Palate / Q000294:innervation* / Q000601:surgery; D021362:Palate, Hard / Q000294:innervation / Q000601:surgery; D056739:Pterygopalatine Fossa / Q000294:innervation* / Q000601:surgery; D012008:Recurrence; D014277:Trigeminal Neuralgia / Q000601:surgery*
keywords: Descending palatine nerve; Greater palatine foramen; Pterygopalatine canal; Pterygopalatine fossa; Trigeminal neuralgia