Wide Intraoral Surgical Access to the Inferior Alveolar Nerve During Cryotherapy at the Infratemporal Fossa: Technical Modification

Abstract

Trigeminal neuralgia is characterized by unilateral pain in the region supplied by the sensory distribution of the fifth cranial nerve. Pharmacologic therapy is an adequate initial treatment option in 75% of patients. When the Jannetta surgical operation is not available or not indicated and when conservative treatment fails to relieve the pain or the medication has to be discontinued because of side effects, one of the remaining surgical options is cryosurgery in the peripherally distributed nerves that emanate from the trigeminal nerve. This technical note describes a perioperative method for exposing and mobilizing the inferior alveolar nerve (IAN) from its bony canal. This approach provided easy access to infratemporal fossa structures during cryotherapy. This technique represented a further development of the technique previously described by the authors. This method ensured direct visualization of the IAN and wide access to theinfratemporal fossa during IAN cryotherapy. (C) 2018 American Association of Oral and Maxillofacial Surgeons