Case Report
Neurolysis for Treatment of Infraorbital Neuropathy
Ahmet Mahli and Demet Coskun
Department of Anaesthesiology and Reanimation, Gazi University Faculty of Medicine, Ankara, Turkey
CorrespondenceshouldbeaddressedtoDemetCoskun;dcoskun@gazi.edu.tr
Received 1 August 2017; Revised 1 October 2017; Accepted 26 October 2017; Published 14 November 2017
AcademicEditor:VincenzoDiLazzaro
Copyright©2017AhmetMahliandDemetCoskun.isisanopenaccessarticledistributedundertheCreativeCommonsAttribution
License,whichpermitsunrestricteduse,distribution,andreproductioninanymedium,providedtheoriginalworkisproperlycited.
Twopatients,awomanaged34andamanaged56,wereincludedinthestudy.eyreportedtheexistenceofpainintheareasof
theinfraorbitalnerve,which,overthelastfourtofiveyears,aggravatedbythestimuliofeating,laughing,andbeingtouched.2ml
of0.5%lidocainewasadministeredtothesepatientssixtimespercutaneously.Itwasobservedthattheeaseofpainlasteduntilthe
localanesthesialostitseffect,andthepainresumeditsoriginalintensity.Neurolysiswith0.5mlof50%ethanolwasappliedtothe
infraorbitalnerve.isprocedurewasappliedtothefirstpatienttwiceandthreetimestothesecond.ereafter,thepatientswere
curedcompletely.Forthetreatmentofidiopathicchronicinfraorbitalneuropathy,theneurolysisoftheinfraorbitalnerveusing
50% ethanol could be considered as an effective treatment alternative.
1. Introduction
Infraorbital nerve neuralgia is an uncommon element for
facialpain.Itisessentialtomanagefacialpainappropriately
as it often causes pain, and the stimuli of eating, laughing,
and being touched result in irritation. Among a number of
managementoptionspresentforfacialpain,interventionat
the branches of the trigeminal nerve has been proved to be
clinicallyuseful[1,2].Blockingandthenalcoholneurolysis
of the infraorbital nerve using a closed method has never
beendiscussed.Accordingly,forthetreatmentoffacialpain,
we agreed to assess the safety and efficiency of alcohol
neurolysis of the infraorbital nerve. To this aim, we used
a closed method in two patients suffering from idiopathic
chronic infraorbital neuropathy.
1.1.CaseReport1. Awomanaged34complainedaboutbrief
stabbingpainintheinnervatedrightareasoftheinfraorbital
nervethatlastedforfouryears.epainwasaggravatedby
the stimuli of eating, laughing, and being touched. e
intensityofthepainwas5outof10onthevisualanalogscale
(VAS, with 0 indicating no pain and 10 the worst pain
imaginable).Shealsosufferedfrominfrequentexacerbations
whichlastedaboutanhourandthepainintensityofwhich
was 9/10 on the VAS.
1.2.CaseReport2. Amanaged56wasincludedinthestudy.
He complained about brief stabbing pain in the innervated
right areas of the infraorbital nerve that had lasted for five
years, and the pain was defined to be aggravated by the
stimuliofeating,laughing,andbeingtouched.eintensity
ofthepainwas5outof10onthevisualanalogscale(VAS,
with0indicatingnopainand10theworstpainimaginable).
Healsosufferedfrominfrequentexacerbationswhichlasted
abouthalfanhourandthepainintensityofwhichwas9/10
on the VAS.
Beforeconsultingourpainservice,bothpatientshadalso
been assessed by the departments of neurology, otorhino-
laryngology, and maxillofacial surgery. e patients had
first consulted to the department of neurology, where they
were clinically examined and their diagnostic tests were
performed. Magnetic resonance imaging and facial com-
puted tomography scans had also been performed, yielding
no pathological findings. Both of them stated that they had
never previously experienced any trauma and undergone
any face or tooth operation. en, consultation was asked
from the departments of otorhinolaryngology and maxil-
lofacial surgery. ese departments were also not able to
identify any pathology. ereupon, the neurology clinic
diagnosed these patients with idiopathic infraorbital neu-
ropathy and pharmacological treatment was started, from
which neither patient could benefit.
Hindawi
Case Reports in Medicine
Volume 2017, Article ID 2389354, 4 pages
https://doi.org/10.1155/2017/2389354