Consensus guidelines on training, diagnosis, treatment and follow-up care of trigeminal nerve injuries

The aim was to present expert-based guidelines on the management of trigeminal nerve injuries. A two-round multidisciplinary Delphi study was conducted amongst international trigeminal nerve injury experts with a set of statements and three summary flowcharts using a nine-point Likert scale (1 = strongly disagree; 9 = strongly agree). An item was deemed appropriate if the median panel score was within the range of 7-9, undecided if the score was 4-6, and inappropriate if the score was 1-3. Consensus was achieved if at least 75% of panelists scored within one range. Eighteen specialists from dental, medical, and surgical specialties participated in both rounds. Consensus was reached on most statements related to training/services (78%) and diagnosis (80%). Statements related to treatment were mainly undecided due to a lack of sufficient evidence for some of the proposed treatments. Nevertheless, the summary treatment flowchart reached consensus with a median score of eight. Recommendations on follow-up and opportunities for future research were discussed. None of the statements were deemed inappropriate. A set of recommendations and accepted flowcharts are presented; these will aid professionals involved in managing patients with trigeminal nerve injuries.