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Journal of Maxillofacial and Oral Surgery

, Volume 19, Issue 1, pp 54–60 | Cite as

Histopathological Evaluation of Inferior Alveolar Neurovascular Bundle in Cases of Trigeminal Neuralgia

  • Nanda Kishore Sahoo
  • Ankur ThakralEmail author
  • Prabal Deb
  • Indranil Deb Roy
Original Article
  • 14 Downloads

Abstract

Background

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.

Purpose

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.

Results

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.

Conclusion

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.

Keywords

Trigeminal neuralgia Peripheral neurectomy Histopathology Demyelination 

Notes

Funding

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.

Ethical Approval

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.

Informed Consent

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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Copyright information

© The Association of Oral and Maxillofacial Surgeons of India 2019

Authors and Affiliations

  • Nanda Kishore Sahoo
    • 1
  • Ankur Thakral
    • 2
    Email author
  • Prabal Deb
    • 3
  • Indranil Deb Roy
    • 4
  1. 1.Department of Oral and Maxillofacial SurgeryCMDC (SC)PuneIndia
  2. 2.Military Dental CentreDelhi Cantt, New DelhiIndia
  3. 3.Department of PathologyArmy Hospital (R&R)New DelhiIndia
  4. 4.Armed Forces Dental ClinicNew DelhiIndia

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