The efficacy and safety of nerve combing for trigeminal neuralgia without neurovascular compression.

OBJECTIVE: The purpose of our study was to review and evaluate the efficacy and safety of nerve combing without neurovascular decompression for trigeminal neuralgia. METHODS: A retrospective review of 298 patients with trigeminal neuralgia between August 2007 and August 2016 was conducted. The patients were divided into two groups: the A group was treated by nerve combing (34 patients) and the B group received microvascular decompression (264 patients). Surgical outcomes and postoperative complications were compared between the two groups. RESULTS: Pain was completely relieved in 88.2% of group A patients and 92.8% of group B after surgery. The median duration of follow-up was 60 months (range 10-115 months) in group A and 62 months (range 12-118 months) in group B. 72.7% and 86.4% of cases were completely relieved in groups A and B, respectively. There were no statistically significant differences in the surgical outcomes between the two groups. Almost all patients experienced some degree of numbness or hypesthesia (76.5%). The rate of facial numbness in group A was significantly higher than that in group B. CONCLUSION: This study demonstrated that nerve combing without neurovascular decompression is a safe and effective treatment for trigeminal neuralgia. However, a majority of patients treated with nerve combing experienced some degree of facial numbness.