Nerve combing for trigeminal neuralgia without vascular compression

Abstract

Objective To evaluate the efficacy and safety of nerve combing for trigeminal neuralgia without neurovascular decompression. Methods A retrospective review of clinical data of 281 patients with trigeminal neuralgia, admitted to our hospital from January 2008 to January 2016, was performed. The patients were divided into two groups: patients from group A were treated by nerve combing (n=32), and patients from group B were treated by microvascular decompression (n=249). The two groups were compared in terms of surgical outcomes and postoperative complications. Results The pain was completely relieved in 90.6% patients of group A (29/32) and 94.4% patients of group B (235/249), respectively; the mean follow-up duration was 62.5 months in group A, and 78.1% patients (25/32) were completely relieved; the mean follow-up duration was 59.8 months in group B, and 84.1% patients (201/239)were completely relieved; no statistically significant differences existed in the surgical outcomes and long-term outcomes between the two groups (P>0.05). No complications related to severe disability or death were noted in the two groups. The rate of facial numbness in patients from group A (71.9%) was significant higher than that in group B (2.5%, P<0.05). Conclusions Nerve combing is a safe and effective treatment for trigeminal neuralgia without neurovascular decompression. Most patients treated with nerve combing experienced some degrees of facial numbness. Key words: Trigeminal neuralgia; Nerve combing; Microvascular decompression; Vascular compression