Neuromodulation of the lingual nerve: a novel technique

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  • 1 Departments of Neurological Surgery and
  • 3 Otolaryngology–Head & Neck Surgery,
  • 2 Rutgers New Jersey Medical School, Newark, New Jersey
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Acute injury of the trigeminal nerve or its branches can result in posttraumatic trigeminal neuropathy (PTTN). Affected patients suffer from chronic debilitating symptoms long after they have recovered from the inciting trauma. Symptoms vary but usually consist of paresthesia, allodynia, dysesthesia, hyperalgesia, or a combination of these symptoms. PTTN of the trigeminal nerve can result from a variety of traumas, including iatrogenic injury from various dental and maxillofacial procedures. Treatments include medications, pulsed radiofrequency modulation, and microsurgical repair. Although trigeminal nerve stimulation has been reported for trigeminal neuropathy, V3 implantation is often avoided because of an elevated migration risk secondary to mandibular motion, and lingual nerve implantation has not been documented. Here, the authors report on a patient who suffered from refractory PTTN despite multiple alternative treatments. He elected to undergo novel placement of a lingual nerve stimulator for neuromodulation therapy. To the best of the authors’ knowledge, this is the first documented case of lingual nerve stimulator implantation for lingual neuropathy, a technique for potentially reducing the risk of electrode migration.

ABBREVIATIONS ENT = ear, nose, and throat; PTTN = posttraumatic trigeminal neuropathy.

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Contributor Notes

Correspondence Boris Paskhover: Rutgers New Jersey Medical School, Newark, NJ. borpas@njms.rutgers.edu.

INCLUDE WHEN CITING Published online April 24, 2020; DOI: 10.3171/2020.2.JNS193109.

Disclosures Dr. Mammis is a consultant for Medtronic, Abbott, Nevro, and Boston Scientific.

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