Rashi Garg*
Purpose of review: To investigate the current evidence base and clinical indications for various surgical procedures in the management of trigeminal neuralgia (TN). This review is pertinent with the current focus of the health sector to reduce polypharmacy, drug dependence and improve quality of life for chronic pain sufferers.
Recent findings: The current review outlines the various peripheral, central, ablative and non ablative surgical techniques that have been employed. Clinical outcomes with success rates, recurrence rates are discussed. More importantly, we noted downwards trend of morbidity and mortality of surgical complications over the last decade.
Summary: Surgical interventions have a place in the management of TN, and orofacial pain specialists should at least be familiar with them and be able to provide rational advice to patients. Surgical treatments divide into two main categories: ablative (destroying the nerve) or non-ablative (preserving nerve function and relieving the pressure on the nerve). Prognostic factors have evolved to favour diagnostic accuracy, older patients, and non- ablative surgery i.e., microvascular decompression.
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