饶了我的牙齿吧！牙科手术与三叉神经痛。
Please spare my teeth! Dental procedures and trigeminal neuralgia.
作者信息
Tripathi Manjul, Sadashiva Nishanth, Gupta Anand, Jani Parth, Pulickal Sachin Jose, Deora Harsh, Kaur Rupinder, Kaur Parwinder, Batish Aman, Mohindra Sandeep, Kumar Narendra
机构信息
Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.
出版信息
Surg Neurol Int. 2020 Dec 22;11:455. doi: 10.25259/SNI_729_2020. eCollection 2020.
BACKGROUND
The correct diagnosis of trigeminal neuralgia (TN) is still a far cry and the patients suffer from unnecessary dental procedures before getting the definite treatment. In this study, we evaluated, if the patients have undergone dental procedures for their misdiagnosed TN before receiving definite treatment for the same.
METHODS
A total of 187 patients received GKRS for their TN (excluding secondary TN) in two institutes from 2010 to 2019. We did a retrospective analysis of these patients' primary complaints on a standard questionnaire.
RESULTS
One hundred and seventeen of the 187 patients responded. About 55.5% of patients had a toothache and 65.8% did visit a dentist for the pain. About 41.8% of patients underwent one dental procedure; 18.8% suffered from worsening of the pain while 8.5% received some partial improvement. About 19.6% also underwent root canal treatment while 6.8% had a nerve block. Mean of 1.6 teeth was extracted per person. About 71% of patients were satisfied with their Gamma Knife radiosurgery for TN at a median follow-up of 49 months.
CONCLUSION
There is a need for a better understanding of the disease among the dentists and the patients for the timely and correct treatment, without losing their teeth. The onus lies on neurosurgeons/neurologists disseminate knowledge regarding proper diagnosis and treatment modalities.
背景
三叉神经痛（TN）的正确诊断仍存在很大差距，患者在接受明确治疗之前会接受不必要的牙科治疗。在本研究中，我们评估了患者在因误诊的TN接受明确治疗之前是否接受过牙科治疗。
方法
2010年至2019年期间，共有187例TN患者（不包括继发性TN）在两家机构接受了伽玛刀放射外科治疗（GKRS）。我们在一份标准问卷上对这些患者的主要诉求进行了回顾性分析。
结果
187例患者中有117例做出了回应。约55.5%的患者有牙痛，65.8%的患者因疼痛去看过牙医。约41.8%的患者接受了一项牙科治疗；18.8%的患者疼痛加重，8.5%的患者有部分改善。约19.6%的患者还接受了根管治疗，6.8%的患者进行了神经阻滞。人均拔牙1.6颗。在中位随访49个月时，约71%的患者对其TN的伽玛刀放射外科治疗感到满意。
结论
牙医和患者需要更好地了解这种疾病，以便及时正确治疗，而不致牙齿脱落。神经外科医生/神经科医生有责任传播有关正确诊断和治疗方式的知识。
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