An approach of trigeminal nerve block via pterygopalatine fossa under ultrasound-guidance in the treat-ment of trigeminal neuralgia

Abstract

Objective To explore the approach of trigeminal nerve block via pterygopalatine fossa under ultrasound-guidance in the treatment of trigeminal neuralgia. Methods Five patients with primary trigeminal neuralgia and two patients with trigeminal neuralgia after herpes zoster received trigeminal nerve block under ultrasound-guidance via sigmoid incisure of mandible into pterygopalatine fossa. Superficial sensory in the cutaneous distribution area of the branches of trigeminal nerve pain was observed respectively after 15 minutes. The efficacy was assessed by visual analogue scale (VAS) before and at 24 h, 1 month and 3 months after the treatment, and the occurrence of complications was observed as well. Results The branches V1, V2, V3 of trigeminal nerve were all blocked in 2 patients (29%) , V2 and V3 in 4 patients (57%) and V2 in 7 patients (100%) . The effective rate was 100% at 24 h, 1 month, 3 months after the treatment. VAS in 5 patients with primary trigeminal neuralgia was significantly lower at 3 months after the treatment than that before the treatment, without obvious decrease in two patients with trigeminal neuralgia after herpes zoster. One patient showed facial swelling for two hours, without other complication. Conclusion Trigeminal nerve block via pterygopalatine fossa under ultrasound-guidance is a safe and effective approach in the treatment of trigeminal neuralgia. Key words: Trigeminal nerve; Trigeminal neuralgia; Pterygopalatine fossa; Nerve block; Ultrasound-guidance