SURGICAL TREATMENT FOR FACIAL PAIN

Abstract

Introduction. Different types of facial pain (FP) are the chronic, intractable diseases of the nervous system. To improve the effectiveness of surgery in patients with FP, to reduce the number of unnecessary invasive procedures and to increase the number of favorable outcomes, it is needed to use algorithms for choosing the most preferable interventions. Objective is to evaluate the effectiveness of the proposed algorithm in the treatment of the FP in the practice of a neurosurgical hospital on a large number of patients, the development of algorithms for differentiated treatment of patients with the different etiologies of FP syndrome and to review the literature in light of the effectiveness of different types of interventions. Materials and methods. The proposed algorithm was tested in 382 patients (128 men and 254 women) with different types of FP. Patients were treated in 4 hospitals from 2000 to 2016. Results. The pain relief more than 25 % of the initial intensity of pain was detected in 78.2 % of patients in the follow-up period in all types of surgical interventions when using the algorithm. Conclusion. The choice of the type of surgical intervention is based primarily on clarifying the etiopathogenetic mechanisms of the development of pain syndrome. This requires a comprehensive examination of patients using methods such as magnetic resonance imaging, the use of the T2 3D-CISS, the tractography of the trigeminal nerve root, the use of a contrast to diagnose the cause of FP. To select the optimal type of treatment, it is proposed to use algorithms, which reflect the most preferred methods.