Aim and objective: The present study was conducted to evaluate the efficacy of peripheral neurectomy (PN) in the management of trigeminal neuralgia (TN) not responsive to medical management.
Materials and methods: Patients diagnosed with refractory TN not fit for major surgery or not willing for the neurosurgical intervention were enrolled for the study. The success of the surgery was assessed by pain score in the postoperative period [measured by visual analog scale (VAS)]. Quality of life (QOL) of patients was evaluated using the Short-Form Health Survey (SF-36) tool consisting of eight domains, measuring both the physical and mental components of wellbeing. The statistical analysis was done by using IBM SPSS® software version 25 (IBM Corp., USA). The mean value and standard deviation for each of the parameters were considered and checked for statistical significance using the analysis of variance (ANOVA) test. The difference was considered significant if p < 0.05.
Results: Thirty-five neurectomies were performed in 31 patients. Patients were on carbamazepine therapy for 6–60 months, with an average dose of 812.90 mg/day. Mandibular division was most commonly involved (n = 18; 58%), followed by maxillary (n = 7; 23%), and ophthalmic division (n = 2; 6%). The earliest recurrence of pain was seen at the sixth month in one patient. At the 1st year follow-up, poor and fair control of pain were seen in 3 (10%) and 10 (32%) patients, respectively. At the 3 years, recurrence was seen in 32.25% (n = 10) patients. There was an improvement in QOL score immediately after PN, which despite the decrease on long-term follow-up, was considerably above the preoperative value.
Conclusion: Peripheral neurectomy is a simple, minimally invasive option for the management of refractory TN. Although recurrence is a limitation for its long-term success, it does help to achieve pain control and improve QOL.
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