title: Magnetic resonance neurography in the management of peripheral trigeminal neuropathy: experience in a tertiary care centre.
abstract: OBJECTIVE
  This tertiary care experience examines the utility of magnetic resonance neurography (MRN) in the management of peripheral trigeminal neuropathies.
  
  
  METHODS
  Seventeen patients with clinically suspected peripheral trigeminal neuropathies (inferior alveolar nerve and lingual nerve) were imaged uniformly with 1.5-T examinations. MRN results were correlated with clinical and surgical findings in operated patients and the impact on clinical management was assessed.
  
  
  RESULTS
  Clinical findings included pain (14/17), sensory changes (15/17), motor changes (2/17) and palpable masses (3/17). Inciting events included prior dental surgery (12/17), trauma (1/17) and idiopathic incidents (4/17). Non-affected side nerves and trigeminal nerves in the intracranial and skull base course were normal in all cases. Final diagnoses on affected sides were nerve inflammation (4/17), neuroma in continuity (2/17), LN transection (1/17), scar entrapment (3/17), infectious granuloma (1/17), low-grade injuries (3/17) and no abnormality (3/17). Associated submandibular gland and sublingual gland oedema-like changes were seen in 3/17 cases because of parasympathetic effects. Moderate-to-excellent MRN-surgical correlation was seen in operated (8/17) patients, and neuroma and nerve transection were prospectively identified in all cases.
  
  
  CONCLUSIONS
  MRN is useful for the diagnostic work-up of suspected peripheral trigeminal neuropathy patients with significant impact on clinical management and moderate-to-excellent correlation with intra-operative findings.
  
  
  CONCLUSIONS
  • MRN substantially impacts diagnostic thinking and management in peripheral trigeminal neuropathy. • MRN has moderate-to-excellent correlation with intra-operative findings. • MRN should be considered in pre-surgical planning of peripheral trigeminal neuropathy subjects.
authors.affiliation: Department of Radiology, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9178, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Cox
authors.affiliation: Department of Oral & Maxillofacial Surgery, Surgery, Neurology & Neurotherapeutics, UT Southwestern Medical Center, Dallas, TX, USA.
authors.forename: John R
authors.initials: JR
authors.lastname: Zuniga
authors.affiliation: Department of Oral Maxillofacial Surgery, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Neeraj
authors.initials: N
authors.lastname: Panchal
authors.affiliation: Department of Plastic Surgery, UT Southwestern Medical Center, Dallas, TX, USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Cheng
authors.affiliation: Department of Radiology, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9178, USA. avneesh.chhabra@utsouthwestern.edu.
authors.forename: Avneesh
authors.initials: A
authors.lastname: Chhabra
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D062606:Tertiary Care Centers; D020433:Trigeminal Nerve Diseases / Q000175:diagnosis* / Q000601:surgery
keywords: Inferior alveolar nerve; Lingual nerve; MRN; Neurography; Trigeminal nerve