Trigeminal neuralgia lesion curettage

With the advancement of research on primary trigeminal neuralgia, the understanding of the diseased bone cavity of the jaw has gradually deepened. The maxillary lesional bone cavity (hereinafter referred to as the bone cavity) is located in the bone marrow cavity of the upper and lower jaw bones. Most of the maxillary bone cavity is located below the maxillary sinus floor; the bone cavity of the mandible is mostly above the inferior alveolar nerve canal. Jiao Xiyu (1984) reported that in 350 bone cavities, 91.12% of the bone cavity was within 1.2 cm in diameter and the largest bone cavity was 5 cm. There may be one to several bone cavities, some of which are scattered away from the bone cavity, and some of the bone cavities are connected by narrow passages. The contents of the bone cavity are mainly loose bone marrow tissue, broken bone fragments or bone spurs, which are easily scraped off. A few large bone cavities are a cavity with few loose connective tissue and broken bone fragments. The wall of the bone cavity is generally hard, and it is not easy to bleed when scraping. The relationship between the diseased bone cavity of the jaw and the pain symptoms of the trigeminal nerve is reflected in the relationship between the bone cavity and the trigger point. The slap point is the starting point of trigeminal pain. Clinical practice has proved that all kinds of slap points have a close relationship with the bone cavity. The slap point is the sign of the diseased bone cavity. Even the ectopic pull point away from the bone cavity or jaw bone is closely related to a specific bone cavity. However, for cases with multiple slap points and multiple lesions, the positioning of the bone cavity is difficult. Because the diseased bone cavity of the jaw bone is located between the inner and outer plates of the jaw, it is difficult to determine the location of the conventional X-ray photograph, and the positive rate of diagnosis is generally about 30%. Therefore, according to the regularity of the relationship between the slap point and the bone cavity, the slap point tracking and positioning method combined with the performance of the X-ray photograph is a reliable method for accurately determining the position of the diseased bone cavity. Due to the discovery of the diseased bone cavity of the jaw, the efficacy of the treatment of primary trigeminal neuralgia with the treatment of maxillary bone cavernectomy is affirmative. Treating diseases: trigeminal neuralgia Indication Patients with primary trigeminal neuralgia undergo physical examination, X-ray photographs, local anesthesia to stop the attack, etc., determine the trigger point, and find the diseased bone cavity, then perform pathological bone cavity curettage. Contraindications 1. Undiagnosed as primary trigeminal neuralgia. 2. The trigger point and the lesioned bone cavity were not found. Preoperative preparation 1. Detailed medical history, careful positioning examination, to find out whether it is primary or symptomatic trigeminal neuralgia, providing a basis for surgery. 2. For patients with a wide range of facial episodes of severe pain, distinguish the primary and secondary, and do a good job before the operation. 3. For young or menopausal women, facial pain occurs, and the diagnosis should be carefully diagnosed before surgery, especially to eliminate the pain caused by mental factors. 4. For patients undergoing surgery from the oral route, the teeth should be cleaned and the mouth should be cleaned before surgery to treat the odontogenic infection. 5. For patients undergoing surgery under general anesthesia, perform a general examination before surgery to understand the function of heart, lung, liver and kidney. Surgical procedure For the lesional bone cavity of the jaw, the mucosa and periosteum are incision, and the superficial cortical bone is excised, that is, into the bone cavity. There may be loose bones in the cavity, sometimes soft and fragile tissue, and scraped one by one. Sometimes there is a small fistula in the deep or lateral side, which can be connected to the second bone cavity and should be scraped. Then, it was washed with physiological saline and 3% hydrogen peroxide, washed, and then injected with an antibiotic solution to suture the wound. If there is a recurrence, you can further find a new point or bone cavity and continue processing. If the trigger point is near the root of the tooth, the tooth is sensitive to the examination and the pain is triggered. The alveolar fossa wall was carefully examined to find the diseased bone cavity or bony fistula. If there is a lesion, cure it and trim the wall with a slow round drill. For individual cases where the slap point is clearly located in the soft tissue, regardless of the jaw bone. The lesion may be in the fascial space or muscle, and it can be observed in this part by injection of antibiotics. complication Patients with lesions of the jaw bone had no significant complications after surgery. Do not repeat them.