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A retrospective study of neurocombing for the treatment of trigeminal neuralgia without neurovascular compression

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Abstract

Background

Microvascular decompression (MVD) is the most effective and non-ablative treatment for trigeminal neuralgia (TN). However, it is not possible when neurovascular compression (NVC) is absent. Neurocombing is a possible treatment option for TN patients without NVC.

Aim

To evaluate and describe the clinical outcome of neurocombing for the treatment of TN when NVC was absent.

Methods

We retrospectively reviewed the clinical data of the 37 patients of Type 1 TN without NVC who underwent neurocombing in our department between January 2013 and November 2014. The Barrow Neurological Institute (BNI) Pain Intensity scale, the numerical rating scale (NRS) and the quality of life scale (QOL) were evaluated in four stages—presurgical, immediate, at 1 and at 3 years. Pain recurrence was statistically evaluated with Kaplan–Meier analysis.

Results

All the 37 enrolled patients were proved to have no NVC by imaging or exploration in surgery. The mean follow-up duration was 29.50 months. After the procedure, 35 patients (94.6%) experienced immediate pain relief (BNI I) and 2 patients (5.4%) had occasional pain without any medication (BNI II). At 1 year and 3 years, the rates of successful pain relief (BNI I&II) were 86.5 and 83.3%, respectively. 34 patients (91.9%) suffered from mild facial numbness, while it did not exert a harmful impact on their quality of life.

Conclusions

This study demonstrated that neurocombing is an attractive, effective, safe and durable treatment option for TN when NVC is absent. Further study is needed to explain the complicated and exact mechanism of pain relief by neurocombing.

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Acknowledgements

This study was supported by a grant from Hangzhou Science and Technology Research Fund Project (No. 20140633B01).

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Authors and Affiliations

  1. The Department of Neurosurgery, Hangzhou First People’s Hospital, 261 Huan Sha Road, Shang Cheng District, Hangzhou, 310006, China

    X. Liang, X. Dong, S. Zhao, X. Ying, Y. Du & W. Yu

  2. Zhejiang Chinese Medical University, 548 Bin Wen Road, Bin Jiang District, Hangzhou, 310053, China

    X. Liang, S. Zhao & X. Ying

  3. The Department of Neurosurgery, Zhejiang Provincial Hospital of Traditional Chinese Medicine, 54 You Dian Road, Shang Cheng District, Hangzhou, 310006, China

    X. Liang

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  1. X. Liang
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  2. X. Dong
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  6. W. Yu
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Correspondence to W. Yu.

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Statement of human rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

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Informed consent was obtained from all individual participants included in the study.

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The authors declare that they have no conflict of interest.

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Liang, X., Dong, X., Zhao, S. et al. A retrospective study of neurocombing for the treatment of trigeminal neuralgia without neurovascular compression. Ir J Med Sci 186, 1033–1039 (2017). https://doi.org/10.1007/s11845-016-1547-y

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  • DOI: https://doi.org/10.1007/s11845-016-1547-y

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