"Nerve combing" for trigeminal neuralgia without vascular compression: report of 10 cases

The purpose of this study was to describe and evaluate the contributions of "nerve combing" to trigeminal neuralgia (TN) without vascular compression.

Ten of 96 cases with TN who intended to be treated with microvascular decompression in our clinic had no visible vascular compression intraoperatively. The operative procedure for all 10 patients was nerve combining.

At least 3 years after surgery, 7 of 10 patients were pain-free after nerve combing. One patient had little pain relief. One patient experienced significant partial relief, and the intensity of the residual pain in this patient was not severe enough to require medication. Recurrence occurred in 1 case 18 months postoperatively. Permanent sensory deficits were present in 1 patient.

Minimal trigeminal nerve root trauma via nerve combining technique demonstrated a beneficial impact on TN within this cases series. Further studies should be carried out to explore the possible mechanisms of underlying pain and to assess outcomes with respect to currently available medical and surgical treatment options.