Effects of stellate ganglion block on traumatic trigeminal neuropathy

Abstract

   Background: Trigeminal neuropathy following dental treatment is one of the most difficult conditions to treat. Prolonged abnormal sensation tends to be observed in cases whose nerves were moderately or severely damaged. We previously reported that the severity of nerve injury could be measured with electric and tactile detection thresholds. The purpose of this study was to investigate if stellate ganglion block (SGB) started immediately after nerve injury could be an effective treatment procedure.
   Methods: The present study included 64 damaged and 15 intact trigeminal divisions in 59 patients. Electric detection threshold (EDT) one week after the injury was measured and all divisions were estimated to have an equivalent severity of damage. Damaged nerves were divided into three groups. 1) Nerves followed up without SGB (NSGB: n=17). 2) Nerves that were treated with SGB within two weeks of injury were classified ESGB (n=28), and 3) those with treatment commencing later than two weeks were LSGB (n=19). EDT and type of abnormal sensation (hypoesthesia, allodynia, hyperalgesia and dysesthesia) were periodically recorded throughout twelve months from the injury. EDT in 15 contralateral divisions was repeatedly measured to assure its reproducibility.
   Results: Recovery from hypoesthesia was significantly better in ESGB than other two groups and better in LSGB than NSGB. Furthermore, other types of abnormal sensation on twelve months following injury were less frequently in ESGB.
   Conclusions: These results suggest that early SGB prevented aggravation of the pathology and accelerated recovery of nerve function.