Histopathological Evaluation of Inferior Alveolar Neurovascular Bundle in Cases of Trigeminal Neuralgia
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Trigeminal neuralgia is a painful disease that has been afflicting mankind since time immemorial. The etiology and pathophysiology have been widely studied but poorly understood. There are well-documented researches analyzing ultrastructural changes in trigeminal root specimens obtained following microvascular decompression surgery. However, there are no studies evaluating microscopic changes following peripheral neurectomy.
The present study examined microscopic changes in inferior alveolar neurovascular bundle in trigeminal neuralgia patients of mandibular division with no underlying cause.
Materials and Methods
The biopsy specimens were obtained from peripheral neurectomy of 11 trigeminal neuralgia patients’ refractory to anti-neuralgic medications. The autopsy specimens from 10 cadavers were used as control. The specimens were subjected to histopathological examination by hematoxylin and eosin, Masson trichrome and Luxol fast blue stains.
All biopsy specimens reported luminal occlusion of small vessels, medial degeneration and intense mononuclear inflammatory infiltrate. Focal myelin digestion chambers were observed in large and small axons. No pathological alterations of either blood vessel or nerve fibers were reported in autopsy specimens.
The demyelination of inferior alveolar nerve due to pathologic vascular changes in peripheral vasculature may have a role in initiation and precipitation of trigeminal neuralgia, and hence, peripheral neurectomy has a significant role in alleviating pain.
KeywordsTrigeminal neuralgia Peripheral neurectomy Histopathology Demyelination
This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.
Compliance with Ethical Standards
Conflict of interest
All authors have no conflict of interest to declare.
All procedures involved in the present study involving human participant 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. This article does not contain any studies with animals performed by any of the authors. Institutional ethical committee approval was obtained from Armed Forces Medical College, Pune. Protocol No: OMFS/1/2014 version 1.
Written informed consent was obtained from patients included in the study. However, article included only histopathological pictures and no clinical photographs.
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