Nervus Intermedius Sectioning with other procedures displayed no severe complications and offered pain-free survival in nervus intermedius neuralgia

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Nervus Intermedius Sectioning with other procedures displayed no severe complications and offered pain-free survival in nervus intermedius neuralgia

According to the Department of Neurological Surgery, Oregon Health & Science University, the sectioning of nervus intermedius to treat Nervus intermedius neuralgia (NIN) displayed no severe complications. NIN is a rare type of craniofacial neuralgia which includes lancinating, sharp pain deep in the ear and alongside the trigeminal neuralgia (TN).

There are decidedly fewer evidence to associate intraoperative findings, postoperative outcomes and clinical presentation. Therefore, this retrospective cohort study was conducted to investigate nervus intermedius (NI) sectioning related surgical/clinical findings. The patients who suffered from NIN and went through neurological treatment at the same institution from 2002 to 2016 were included in the study. A revised facial pain and quality of life questionnaire were used determine pain-free survival that recorded via chart review and phone interviews. Kaplan-Meier curves were used to represent these pain-free survival data.

Fifteen patients were elected who met the study criteria. Out of 15 patients, 14 went through NI sectioning, eight patients among these had concomitant TN. A reduction in pain was seen among thirteen out of 14 patients after the surgery. Five patients were found to have visible neurovascular compression (NVC) of NI by the anterior inferior cerebellar. The patients were followed up for 6.41 years. Diplopia, tinnitus, temporary facial nerve palsy, dizziness, ear fullness and vertigo were the common complications found after the treatment. Six out of fourteen patients found to have pain recurrence. At the most extended follow-up, four patients with isolated NIN and then obtained NI sectioning alone reported worse or the same pain scores than before the surgery. It indicates that individual NI sectioning was not adequate. The median pain-controlled survival and median pain-free survival reported was 6.22 years ± 15.78 and 4.82 years ± 14.85 months respectively. The pathophysiology of NIN is yet not clearly understood. Neurovascular compression does not play an essential role in NIN pathophysiology and shows the high degree of overlap with TN. For NIN management, NI sectioning imparts a significant role without any significant complications like deafness or permanent facial weakness.

Source:

Journal of Neurosurgery

Link:

https://www.ncbi.nlm.nih.gov/pubmed/30117769

Original title of article:

Pain-free and pain-controlled survival after sectioning the nervus intermedius in nervus intermedius neuralgia: a single-institution review.

Authors:

Katherine G.Holste et al.

SearchTags: 
Therapeutic, Ear Pain, Retrospective Cohort Study, Efficacy
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