학술논문

Internal neurolysis: 'nerve combing' for trigeminal neuralgia without neurovascular conflict – early UK outcomes.
Document Type
Article
Source
British Journal of Neurosurgery. Apr2022, Vol. 36 Issue 2, p175-178. 4p. 1 Color Photograph, 2 Charts, 3 Graphs.
Subject
*TRIGEMINAL neuralgia
*BRIEF Pain Inventory
*TRIGEMINAL nerve
*CRANIOTOMY
*NERVES
*FACIAL pain
Language
ISSN
0268-8697
Abstract
Internal neurolysis (INL) is a surgical procedure where trigeminal nerve fibres are separated between the pons and porus trigeminus to relieve trigeminal neuralgia (TN). We report pain and functional outcomes to evaluate its safety and efficacy. Prospective cohort of all patients undergoing retrosigmoid craniotomy and INL between 2015 and 2017 at University Hospital Southampton. Patients with type I (6) or type II (2) refractory TN and no clear neurovascular conflict were offered INL as an alternative to partial sensory rhizotomy. Barrow Pain Intensity Scale (BNI) and Brief Pain Inventory Facial scores (BPI-Facial) were assessed. Minimum follow-up was 2 years'. Eight patients (7F:1M) underwent INL. Two had MS. Pre-operatively, all had severe pain (BNI grade V) and the median BPI-Facial score was 115 (range 79–123).. There were no unexpected complications. On last follow-up, six (75%) had no pain (BNI grade I), while two (25%) had recurred (at 5 and 27 months). Median BPI-Facial score for all patients on the last follow-up was 20 (range 18–91) reflecting dramatically improved quality of life and activities. INL is a potentially safe and effective treatment for refractory TN. Long-term efficacy is unknown, but early results are promising. [ABSTRACT FROM AUTHOR]