Pterygopalatine fossa segment neurectomy of maxillary nerve through maxillary sinus route in treating trigeminal neuralgia

✓ A new tool in neurophysiological exploration of the trigeminal nerve has recently been introduced. It has been demonstrated that stimulation of the infraorbital nerve trunk gives rise to very reliable scalp responses reflecting the activity of the afferent pathway between the maxillary nerve and the brain stem. The authors demonstrate that alterations of such trigeminal evoked responses fit with documented pathological processes at various locations along the trigeminal pathway (maxillary sinus, parasellar region, and within the brainstem parenchyma). They report the findings in 68 patients suffering from “idiopathic” trigeminal neuralgia. Alterations of the response were detected in 33 cases, suggesting that some damage of the nerve had taken place either at the root entry zone into the pons (23 cases) or slightly distal to it (10 cases). Such results support the hypothesis that trigeminal neuralgia may be due to a compression of the trigeminal root at the pons entry zone.

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Treatment of a subtype of trigeminal neuralgia with descending palatine neurotomy in the pterygopalatine fossa via the greater palatine foramen–pterygopalatine canal approach

Journal of Cranio-Maxillofacial Surgery ◽

10.1016/j.jcms.2014.10.016 ◽

2015 ◽

Vol 43 (1) ◽

pp. 97-101 ◽

Cited By ~ 5

Author(s):

Junbing Guo ◽

Daiyin Huang ◽

Songling Chen ◽

Shuangxi Zhu ◽

Qiong Rong

Keyword(s):

Trigeminal Neuralgia ◽

Pterygopalatine Fossa ◽

Greater Palatine Foramen

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Solitary Neurofibroma of the Maxillary Sinus and Pterygopalatine Fossa

Otolaryngology ◽

10.1016/j.otohns.2005.01.006 ◽

2005 ◽

Vol 133 (3) ◽

pp. 458-459 ◽

Cited By ~ 19

Author(s):

Carsten Christof Boedeker ◽

Gerd Jürgen Ridder ◽

Gian Kayser ◽

Jörg Schipper ◽

Maier Wolfgang

Keyword(s):

Maxillary Sinus ◽

Pterygopalatine Fossa ◽

Solitary Neurofibroma

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Breast Cancer Metastasis Involving Pterygopalatine Fossa: A Cause of Trigeminal Neuralgia

Headache The Journal of Head and Face Pain ◽

10.1111/j.1526-4610.2004.04178_1.x ◽

2004 ◽

Vol 44 (9) ◽

pp. 927-928 ◽

Cited By ~ 5

Author(s):

Sait Albayram ◽

Ibrahim Adaletli ◽

Hakan Selcuk ◽

Fatih Gulsen ◽

Civan Islak ◽

...

Keyword(s):

Breast Cancer ◽

Trigeminal Neuralgia ◽

Cancer Metastasis ◽

Breast Cancer Metastasis ◽

Pterygopalatine Fossa

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Radiofrequency Thermocoagulation Through Foramen Rotundum Versus Foramen Ovale for the Treatment of V2 Trigeminal Neuralgia

January 2018 - Pain Physician ◽

10.36076/ppj/2019.22.e609 ◽

2019 ◽

Vol 6 (22;6) ◽

pp. E609-E614

Author(s):

Cong-yang Yan

Keyword(s):

Trigeminal Neuralgia ◽

Facial Pain ◽

Operation Time ◽

Controlled Clinical Trial ◽

Gasserian Ganglion ◽

Internal Opening ◽

Foramen Ovale ◽

Maxillary Nerve ◽

Radiofrequency Thermocoagulation ◽

Foramen Rotundum

Background: Percutaneous radiofrequency thermocoagulation through the foramen rotundum (FR) is a new approach for the treatment of V2 trigeminal neuralgia (TN). Objectives: This study aimed to compare the efficacy and safety of the FR approach with that of the foramen ovale (FO) approach. Study Design: Nonrandomized controlled clinical trial. Setting: The study was conducted at Huaian Hospital of Huaian City, Huaian, China. Methods: From July 2014 to December 2016, 80 consecutive patients with V2 TN were prospectively assigned into the FO group (n = 40) or the FR group (n = 40). All radiofrequency thermocoagulation procedures were performed under the guidance of digital subtraction angiography (DSA). Patients in the FO group were treated with Gasserian ganglion ablation through the Hartel approach. Patients in the FR group received ablation of the maxillary nerve at the internal opening of the FR. Facial pain was evaluated using the Visual Analog Scale preoperatively and postoperatively at 1 week, 6 months, and 1 year. Results: All surgical procedures were successfully completed using DSA guidance. The FR group had no facial pain at postoperative 1 week, 6 months, and 1 year. The facial fain was not relieved in 4 patients of the FO group. They were treated with radiofrequency thermocoagulation of the maxillary nerve through the FR and maintained painless at postoperative 1 week, 6 months, and 1 year. At postoperative 1 year, another 3 patients relapsed in the FO group. The incidences of facial numbness and swelling did not differ significantly between the 2 groups (all P > 0.05). There was no postoperative corneal involvement or masticatory weakness in the FR group. However, corneal involvement and masticatory weakness occurred postoperatively in 22 (55%) patients and 31 (77.5%) patients in the FO group. The FR group had significantly shorter operation time than the FO group (19.3 ± 5.9 vs. 32.7 ± 8.7 minutes; P < 0.05). Limitations: We were unable to avoid the V1 and V3 branches, despite multiple adjustments of the needed position in 35 of the 40 patients in this group. Conclusions: For the treatment of V2 TN, thermocoagulation of the maxillary nerve through the FR had better efficacy and fewer complications in comparison with the Gasserian ganglion ablation through the FO

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Prevalence of Trigeminal Neuralgia in Patients with Chronic Facial Pain in Neurology Lrh Hospital Peshawar.

American Journal of Health, Medicine and Nursing Practice ◽

10.47672/ajhmn.875 ◽

2021 ◽

Vol 6 (6) ◽

pp. 1-7

Author(s):

Saad Ali ◽

Zahwa Salam ◽

Shakir Ullah ◽

Mehtab Alam ◽

Harwindar Kumar

Keyword(s):

Trigeminal Neuralgia ◽

Facial Pain ◽

Tooth Extraction ◽

Age Group ◽

Cross Sectional ◽

Maxillary Nerve ◽

Minimum Age ◽

History Of ◽

The Mean ◽

Hospital Study

Background: Trigeminal Neuralgia (TN) consist of brief periodic but severe and chronic facial pain in acial region in single or multiple branches of the trigeminal nerve. Objective: The objective of this study was to find the prevalence of TN in patients with chronic facial pain. Methodology: This cross sectional observational study was conducted at Department of Neurology OPD Lady Reading Hospital, Peshawar. 46 patients with chronic facial pain were selected for the study. All data was taken on a structured Performa and was entered and analyzed using SPSS version 21. Using non probability consecutive sampling after taking approval from Ethical Committee of the hospital, study duration was 10 months from 25-1-2019 to 25-10-2019. Results: Out of 46 patients, there were 18 (39.1%) males and 28 (60.9%) females. The mean age of the patients was 50.67, the Standard Deviation recorded was 11.56. Minimum age was 21 and maximum age was 67. 23. Out of 31 patients diagnosed with TN had history of tooth extraction and 8 had no extraction. Out of 31 patients presented with TN, right side was involved in 24 (52.2%) patients and left side was involved in 7 (15.2%) patients. Mandibular never was more common in the patients with TN which was 37% followed by maxillary nerve 21.7%, and ophthalmic nerve at 8.7%. Majority of the patients 28 (75.7%) belonged to the age group of 40 to 67. Females having TGN were 78% and males were 50%. Right side (52.2%) was more involved than left side. Mandibular division (37%) was more involved than maxillary and ophthalmic division. Conclusion: We conclude that females are more at risk of developing TN than males. Increasing age has a higher chance of developing TN. Right side is more involved than left. Mandibular division is more involved than maxillary and ophthalmic.

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