IMPORTANCE OF PERIPHERAL NEURECTOMIES IN THE MANAGEMENT OF TRIGEMINAL NEURALGIA

Objective: 50 patients were analyzed for indications, advantages and complications of peripheral neurotomies. Study design: A Retrospective Study. Location and duration: in the Department of Dental and Maxillofacial Surgery Mayo Hospital Lahore for one year duration from July 2017 to July 2018. Methods: We selected patients only over 40 years of age. After neurectomies, 35 (70%) patients had very good relief of pain for 2 to 6 years without any medication; 4 (8%) patients rarely had pain but did not require medication; Drug-controlled pain in 5 (10%) patients; In 6 (12%) patients, pain recurrence in 0-2 years could not be controlled with medication. These patients were referred to a neurosurgeon for MVD (microvascular decompression). Results: Both medical and surgical treatments are effective for trigeminal neuralgia. However, factors such as pain relief, relapse rates, morbidity and mortality rates should be taken into consideration when deciding which technique to use. It seems appropriate to start a patient suffering from trigeminal neuralgia with medical treatment, but if the pain control is poor or the side effects of the drugs are not tolerated, continue with early surgical treatment. Conclusion: Loss of sensation and recurrence rate along the trigeminal nerve branch is associated with peripheral neurectomy. However, it is an safe and effective procedure for elders; especially short-lived ones. If there are no suitable facilities for the main neurosurgical procedures or if the patient does not comply with such procedures, neurectomy is the best option. It is possible even under local anesthesia. Key words: Peripheral neurectomy, Trigeminal neuralgia, Inferior alveolar, Infra-Orbital, Long buccal neurectomy, Mental