In this paper we describe the effects of peripheral cryoneurotomy on a consecutive series of patients with intractable trigeminal neuralgia (TN) who had been treated by a single surgeon over a ten-year period. The results of 55 patients who underwent a total of 102 cryoneurotomies were documented. The age at first cryofreeze was 64 (30-92) years with 24 males and 31 females. Thirty-five had primary TN and 20 secondary TN. The first cryofreeze resulted in 28.2 (5-144) pain free months. Twenty-nine had a second freeze which lasted 34 (2-100) pain-free months and 13 had a third cryofreeze which lasted 26 (1-108) pain free months. Two patients had further freezes. Thirty-four of the primary TN patients had prolonged freedom from pain with one dying perioperatively. The 20 patients with secondary TN had shorter period of pain relief (p<0.05) and one committed suicide. The procedure of peripheral cryoneurotomy is recommended for older, unwell patients with primary TN that is refractory to medical or neurosurgical treatments. It is less effective for dysaesthesia secondary to traumatic nerve injuries.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to British Journal of Oral and Maxillofacial Surgery
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
Classification Subcommittee of the International Headache Society. The international classification of headache disorders. 2nd ed. Cephalalgia 2004;24 Supp 1:9-160.
- Epidemiology and clinical features of idiopathic trigeminal neuralgia and glossopharyngeal neuralgia: similarities and differences, Rochester, Minnesota, 1945-1984.Neuroepidemiology. 1991; 10: 276-281
- Diagnosis and differential diagnosis of trigeminal neuralgia.Clin J Pain. 2002; 18: 14-21
- Trigeminal neuralgia.BMJ Clin Evid. 2009; 2009: 1207
- Phenytoin and carbamazepine in trigeminal neuralgia: marketing-based versus evidence-based treatment.J Pain Res. 2017; 10: 1663-1666
- Interventions for neuropathic pain: an overview of systematic reviews.Anesth Analg. 2017; 125: 643-652
- Practice guidelines for chronic pain management: an updated report by the American Society of Anaesthesiologists Task Force on Chronic Pain Management and the American Society of Regional Anaesthesia and Pain Medicine.Anesthesiology. 2010; 112: 810-833
- Repetitive peripheral neurectomies for neuralgias of the second and third division of trigeminal nerve.J Oral Surg. 1965; 23: 600-608
- Neurosurgical interventions for the treatment of classical trigeminal neuralgia.Cochrane Database Syst Rev. 2011; 9CD007312
- Meta-analysis on safety and efficacy of microsurgical and radiosurgical treatment of trigeminal neuralgia.World Neurosurg. 2017; 103: 757-767
- The effects of extreme cold on sensory nerves.Ann R Coll Surg Engl. 1980; 62: 180-187
- Cryoanalgesia. A new approach to pain relief.Lancet. 1976; 2: 932-934
- Peripheral cryoneurotomy in the treatment of trigeminal neuralgia.Aust Dent J. 1984; 29: 222-224
- Cryoneurotomy for intractable temporomandibular joint pain.Br J Oral Maxillofac Surg. 1988; 26: 26-31
- Use of ultrasound-guided cryotherapy for the management of chronic pain states.J Clin Anesth. 2013; 25: 634-636
- The role of cryoanalgesia for chronic thoracic pain: results of a long term follow up.J Natl Med Assoc. 2002; 94: 716-720
- Effect of peripheral cryoneurotomy and nerve transection on the trigeminal ganglion in rats.Br J Oral Maxillofac Surg. 2019; 57: 341-344
- Complications of an intra-arterial injection from an interior alveolar nerve block.J Am Dent Assoc. 2001; 132: 1702-1704
Published online: September 25, 2020
Accepted: August 12, 2020
© 2020 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.