Vasileios Ragos1, Asimakis Asimakopoulos2, Evangelos Tsiambas3, George Papanastasiou1, George Argyris1, Athanasios Niotis4, Panagiotis Fotiades5, George Psychogios6
1Department of Maxillofacial, Medical School, University Hospital of Ioannina, Ioannina, Greece.
2ENT Department, Luxembourg Hospital Center, Luxembourg.
3Department of Cytology, 417 VA (NIMTS) Hospital, Athens, Greece.
4Department of Surgery, 417 VA (NIMTS) Hospital, Athens, Greece.
5Department of Surgery, 424 General Army Hospital, Thessaloniki, Greece.
6Department of Otorhinolaryngology and Head and Neck Surgery, Medical School University Hospital Ioannina, Greece.
Summary
Purpose: Concerning neuralgias -except the cases characterized as idiopathic- frequent causes include inflammations, trauma, and also tumors that are involved in this painful procedure in the cervix – face area. We describe a surgical modified technique -“functional” neuroctomy (electroplexy)- for encountering trigeminal neuralgia and restoring its clinical image.
Methods: According to the current technique, the overall number of neuralgic cases we handled was three hundred – eighty (n=380). Among them, 205 were located on the third trigeminal branch, 158 on the second branch, whereas the rest of them (n=17) cases were located on the first branch. In the 162 out of the aforementioned 266 cases, the affection occurred only in one branch, in 64 cases the affection occurred in different branches, and in 107 cases the affection occurred in the same branch, in more than one terminal.
Results: In all surgically operated cases the expected results were appropriate. Specifically, we applied neuroctomy, through the oral cavity, to the terminal branches of the trigeminal, and especially to the buccinator, the inferior alveolar, the mandibular, the ofraorbital and the lingual nerve, except the cases regarding the ophthalmic branch (1st branch), in other words, the frontal and supraorbital nerve (intracoutaneous approach). Both the first and the second branch suffered (infraorbital and inferior alveolar nerve), or both suffered, that is the infraorbital and the palatine anterior nerve of the same, the second branch, whereas in the most cases, in 152 out of 266 cases, only one terminal suffered in only one branch (mandibular or nasopalatine nerve).
Conclusions: The application of “functional” neuroctomy (electroplexy) to the stem of the responsible branch –which is the terminal for the treatment of trigeminal neuralgia- proves that it provides a satisfactory therapeutic result (removal of pain), it restores the sensibility of the area sooner than the treatment with amputation neuroctomy, while the percentages of the recurrence remain the same.
Key words: malignancy, neuralgia, trigeminal, surgery, cervicofacial.
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