Iatrogenic Tunnel Syndrome involving Left Inferior Alveolar Nerve Treated with Percutaneous Radiofrequency Ablation of Mandibular Nerve

Abstract

Tunnel Syndrome is described to an increased pressure on peripheral nerves, which leads to impaired neural microcirculation followed by focal demyelination. Such entrapment neuropathy is common in peripheral nerves as a sequel of surgical interventions or alteration in the anatomy. Inferior alveolar nerve is one of the commonest nerves to be involved due to its anatomical location. Percutaneous Radiofrequency Ablation is a non-surgical technique to provide good success in treating long standing neuropathic pain.
A 28-year-old female with inferior alveolar nerve entrapment following multiple surgeries to the left mandible, has presented to our clinic with symptoms of shock like pain and burning sensation over left mandible which aggravates on chewing on the same side, washing face and breeze of wind. Pain is intermittent, short-lasting episodes around 5-6 per day with maximum pain of NRS
8/10 and average NRS of 5/10. Patient was treated with anti-neuropathics and analgesics giving not much relief. Radio frequency ablation of Left mandibular branch of gasserion ganglion was done. Later on, two month follow up her pain score was 0/10.