Introduction: Of the many chronic painful conditions, trigeminal neuralgia (TN) affecting the orofacial region needs the particular attention of physicians and surgeons, especially those specialising in the maxillofacial region. Treatment protocols for the management of classic TN include pharmacology and surgical intervention. Oral and maxillofacial surgeons have traditionally employed the peripheral neurectomy in the surgical management of TN. This review aims to evaluate the efficacy of peripheral neurectomy in the management of TN with regard to (a) the relief of symptoms in comparison with standard neurosurgical procedures and (b) the duration of pain relief and complications observed compared to standard neurosurgical procedures.
Methods: The review of the literature was done according to PRISMA guidelines and included randomised controlled trials, reviews and prospective clinical studies involving surgical procedures for the management of TN. The primary outcomes evaluated were (a) initial relief of pain, (b) duration of relief of pain, (c) complications observed with ablative procedures and (d) recurrence of symptoms. A total of 43 studies fulfilled the inclusion criteria.
Results: In a total of 7913 patients from the 43 studies, central procedures were found to have best results for both quality and duration of pain relief. Percutaneous and peripheral procedures were associated with increased recurrence rates. The consolidated rates of complication for peripheral, percutaneous and central procedures were 39.46, 65.42 and 10.41%, respectively. The use of peripheral neurectomy alone in the management of classic TN was observed in 10 studies.
Conclusion: Peripheral neurectomy in TN is associated with lesser quality of pain relief in comparison with central neurosurgical procedures. It also provides only short- to medium-term pain relief. Most studies with the use of peripheral neurectomy involved only a small group of patients with short follow-up periods. Oral and maxillofacial surgeons must not consider the peripheral neurectomy as the first surgical option in the management of classic TN. Long-term results can be achieved better with appropriate central neurosurgical procedures and pharmacotherapy.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6328817 | PMC |
| http://dx.doi.org/10.1007/s12663-018-1108-1 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Unilateral whisker denervation activates plasticity mechanisms and circuit adaptations in adults. Single nucleus RNA sequencing and multiplex fluorescence in situ hybridization revealed differentially expressed genes related to altered glutamate receptor distributions and synaptogenesis in thalamocortical (TC) recipient layer 4 (L4) neurons of the sensory cortex, specifically those receiving input from the intact whiskers after whisker denervation. Electrophysiology detected increased spontaneous excitatory events at L4 neurons, confirming an increase in synaptic connections.
View Article and Find Full Text PDFOutcomes of wrist denervation and core decompression of the radius for Kienbock's disease.
J Hand Microsurg
January 2025
Columbia University Medical Center/New York Presbyterian Hospital, Department of Orthopedic Surgery, 622 West 168th Street, PH-11 Center, New York, NY, United States.
Background: The definitive treatment of Kienbock's disease has yet to be determined. Wrist denervation combined with core decompression of the radius has not been previously studied as a combined treatment for Kienbock's disease.
Purpose: The purpose of this study was to assess the efficacy of simultaneous wrist denervation and core decompression of the radius in the treatment of Kienbock's disease.
The role of cardiac sympathetic denervation for ventricular arrhythmias: an updated systematic review and meta-analysis.
J Interv Card Electrophysiol
January 2025
Rooney Heart Institute, 311 9th St N #201, Naples, FL, 34102, USA.
Introduction: The role of the sympathetic nervous system in the initiation and continuation of ventricular tachyarrhythmias (VTA) is well established. However, whether CSD reduces implantable cardioverter-defibrillator (ICD) shocks and recurrent VTA is still uncertain.
Methods: A comprehensive literature search was performed at Medline and Embase until March 2023.
Renal denervation in the setting of heart failure.
Heart Fail Rev
January 2025
Department of Cardiology, University Medical Center of the Johannes Gutenberg University, Langenbeckstraße 1, 55131, Mainz, Germany.
Renal Denervation (RDN) has emerged over the last decade as a third pillar in the treatment of arterial hypertension, alongside pharmacotherapy and lifestyle modifications. Mechanistically, it reduces central sympathetic overactivation, a process also relevant to heart failure. In this mini-review, we summarize the development of RDN for heart failure, discuss the current evidence supporting its effects, and provide an outlook on future developments.
View Article and Find Full Text PDFPudendal Neuralgia: A Review of the Current Literature.
Curr Pain Headache Rep
January 2025
Department of Anesthesia, Division of Pain Medicine, University of Virginia, Charlottesville, VA, USA.
Purpose Of Review: This paper aims to review pudendal neuralgia pathophysiology, risk factors, diagnosis, and treatment options.
Recent Findings: Conservative and pharmacologic options are first line treatments for the treatment of pudendal neuralgia. Interventional treatment such as, pudendal nerve blocks can be tried if first line treatments feel to provide adequate analgesia.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!