The long-term outcome of nerve combing for trigeminal neuralgia.

Background: The purpose of our study was to describe and evaluate the long-term clinical outcome of nerve combing for idiopathic trigeminal neuralgia (TN) with and without vascular compression.

Methods: The study included 60 trigeminal neuralgia patients, 28 of which (Group A) had no visible vascular compression intraoperatively and 32 of which (Group B) had trigeminal nerve root entry zone (REZ) compressed by vascular structure. All patients were considered medical failures prior to the surgeries. All of them underwent trigeminal nerve combing. The following outcome measures were assessed: pain relief, recurrence, complication and time to pain relief.

Results: The median duration of follow-up was 52 months (range 48-96 months) in group A and 56 months (range 48-96 months) in group B. Excellent relief and good relief were noted in 23 patients (82.1 %) and two patients (7.1 %) from group A, respectively, and in 20 (62.5 %) and eight patients (25 %) from group B. The major complication of both groups was facial numbness. And the total complication rate was 15.8 % in group A and 18.8 % in group B. Recurrence was found in one patient in group A and in two in group B by the end of follow-up.

Conclusion: Trigeminal nerve combing is effective in treating TN, but has a much higher pain relief rate in patients without vascular compression than those with vascular compression.