Purpose: To investigate the clinical effect of peripheral branch evulsion of trigeminal nerves on trigeminal neuralgia, especially on the aspect of odynolysis and recurrence.
Methods: 136 patients with trigeminal neuralgia underwent peripheral branch evulsion of trigeminal nerves were retrospectively reviewed with three years follow-up period. The odynolysis and recurrence of pain were observed.
Results: Excellent effect was obtained in one patient underwent branch I evulsion. Excellent, good, and no effect were obtained in 57.7% (45/78), 34.6% (27/78), and 7.7% (6/78) of patients underwent branch II evulsion, respectively, with the total effective rate of 92.3%. Excellent and good effect was obtained in 91.1% (82/91) and 8.9% (9/91) of patients underwent branch III evulsion, respectively, with the total effective rate of 100%. During the 3-year follow-up period, no pain recurrence occurred in the patient underwent branch I evulsion, pain recurrence occurred in 24 out of 68 patients underwent branch II evulsion, and in 3 out 72 patients underwent branch III evulsion. Furthermore, pain of branch II occurred in 6 patients underwent branch III evulsion, and pain of branch III occurred in 2 patients underwent branch II evulsion.
Conclusions: The factors of pain recurrence and odynolysis are complicated. Clinically incomplete evulsion may be the main factor. Standard criteria are necessary for identification of pain recurrence and ectopic pain. Electrothermal treatment though infraorbital foramen, buccal nerve evulsion, and ligation of broken nerve are effective to treat odynolysis and pain recurrence.