Endoscope-assisted neurectomy and inferior alveolar nerve avulsion in treating trigeminal neuralgia

Objective: To explore endoscope-assisted surgical treatment for idiopathic trigeminal neuralgia (TN), with neurectomy and avulsion of the inferior alveolar nerve (IAN), when patients are not willing to undergo intracranial procedures.

Clinical materials and methods: Five TN patients with inferior alveolar neuralgia in the mandibular branch were admitted; endoscope-assisted inferior alveolar neurectomy and avulsion was performed for TN treatment. Clinical observation and postoperative follow-up were conducted.

Results: After the operation, all patients had complete relief of pain, with mild postoperative swelling, limited mouth opening, and fast recovery. Patients were followed up for 3-24 months. Facial numbness and paresthesia were felt in the IAN distribution area of the operated side, with no recurrence.

Conclusion: Endoscope-assisted neurectomy and avulsion of the IAN is a safe surgical method to treat TN in the mandibular branch when craniotomy is contraindicated or when patients decline neurosurgical options. It is effective in pain relief, with limited invasiveness and speedy recovery.