Mandibular Nerve Block Guided By Ctin Patients with Trigeminal Neuralgia

Background: Trigeminal neuralgia (TN) is a well-known facial pain syndrome characterized by excruciating paroxysmal shockpain attacks located in somatosensensory distribution of trigeminal nerve. Mandibularaffection is a common presentation of TN.Objectives: Injection of mandibular nerve with neurolytic solutions in trigeminal neuralgia that was unresponsive to pharmacotherapy.Determination of patients and Method: This prospective study included 21 patients treated for mandibular neuralgia by percutaneousinjection of absolute alcohol under guidance of CT image. Their ages ranged from 18-60 years and male to female was 3:4; Allpatients suffered from moderate to severe TN and did not respond to medical treatment. Entry and trajectory of needle was plannedby CT and after local anesthesia. Alcohol was injected at the exit of mandibular nerve from foramen ovale.Results: 85.7% of patients improved: 71.4% became pain free, who became 61.9% after two years of follow up.Conclusion: CT guided mandibular nerve block by neurolytic agent as absolute alcohol and showing its effectiveness as minimalinvasive treatment option for intractable trigeminal neuralgia. CT guidance provided a clear view to secure the safety, accuracyand selectivity of nerve block.