The benefit of surgical management in post-traumatic trigeminal neuropathy: a retrospective analysis

Post-traumatic trigeminal neuropathy (PTTN) is a known complication of common oral and maxillofacial procedures. The burden on the patient and society is often underestimated. This retrospective study included 29 patients with PTTN who underwent surgical treatment. Symptoms were differentiated, pre- and postoperatively, into neuropathic discomfort and loss of perceptive function. Clinical and patient-reported outcomes were recorded. The Brief Pain Inventory questionnaire was completed at the last follow-up. The effect of different variables was evaluated through subgroup analysis. The mean time interval between injury and surgery was 19 weeks. Overall, 20 patients (69%) showed improvement during a mean follow-up of 49 months. Neuropathic pain decreased in most patients (13/18; 72%) and two patients became pain-free. However, 16 patients reported persistent pain on the Brief Pain Inventory questionnaire. Medication use decreased postoperatively. Subgroup analysis showed a positive association between improvement and male sex (Fisher's exact test, P=0.033), and between improvement and the buccal fat nerve wrapping procedure (Fisher's exact test, P=0.02). In conclusion, surgery showed substantial benefit in the treatment of PTTN, even when neuropathic pain was present. The effect of different variables and the potential of buccal fat nerve wrapping should be evaluated further in future research.