Comparison of Cryosurgery and Peripheral Glycerol Injection in Treatment of Trigeminal Neuralgia

Abstract

Background: Trigeminal neuralgia (TN) is a unique debilitating ailment due to its typical symptoms and wide array of surgical treatment modalities available for TN and it is important to select the most appropriate surgical procedure. Aim: To compare the efficacy of peripheral glycerol injection and cryosurgery in the remission of pain in the treatment of trigeminal neuralgia. Methodology: A randomized controlled trial (RCT) study was started after taking ethical approval, total of 80 patients of both gender were included in this study at Department of Oral and Maxillofacial Surgery, Nishtar Institute of Dentistry Multan from July 2017-January 2018. Patients were divided in two equal groups randomly, group A was treated with peripheral glycerol injection and group B with cryosurgery. Patients were followed up for 3rd month to evaluate the efficacy. All results were entered and analyzed in SPSS 24 version. Outcome variables were presented as mean and SD and qualitative variables were presented as frequency/percentages. Probability value ≤0.05 was considered as significant. Results: The efficacy of cryosurgery was observed as (75%), while the efficacy of anhydrous glycerol was noted as (37.5%). This study results support the cryosurgery rather than peripheral glycerol injection in the treatment of trigeminal neuralgia as cryosurgery has higher efficacy and low recurrence rate in controlling pain than peripheral glycerol injection. Efficacy in both groups with age in 40-65 years (p=0.003) was significant. Efficacy in both groups with type of nerve in mental nerve (p=0.030) and inferior alveolar (p=0.039) were significant and infraorbital (p=0.197) and lingual nerve (p=0.386) were not significant. Conclusion: Our study results were supported to the cryosurgery rather than the injection of peripheral glycerol for treatment of trigeminal neuralgia. Keywords; Trigeminal Neuralgia, Peripheral Glycerol injection, Cryosurgery.