Evidence map›Paper›PMID 42116890›Full record

ArticleSurgical neurology international2026

Efficacy of epineurial incision for trigeminal neuralgia without neurovascular compression: Intraneural decompression and morphological restoration.

Keisuke Onoda, Ryousuke Doi, Akira Saitoh, Shunsuke Hatakenaka, Jumpei Kato, Tomihiro Wakamiya, Masahiro Indo, Tatsuya Tanaka, Takashi Agari, Takashi Sugawara and 5 more

Abstract read
In one paragraph

Article in Surgical neurology international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Keisuke OnodaDepartment of Neurosurgery, International University of Health and Welfare, Narita Hospital, Narita City, Japan.
Ryousuke DoiDepartment of Neurosurgery, International University of Health and Welfare, Narita Hospital, Narita City, Japan.
Akira SaitohDepartment of Neurosurgery, International University of Health and Welfare, Narita Hospital, Narita City, Japan.
Shunsuke HatakenakaDepartment of Neurosurgery, International University of Health and Welfare, Narita Hospital, Narita City, Japan.
Jumpei KatoDepartment of Neurosurgery, International University of Health and Welfare, Narita Hospital, Narita City, Japan.
Tomihiro WakamiyaDepartment of Neurosurgery, International University of Health and Welfare, Narita Hospital, Narita City, Japan.
Masahiro IndoDepartment of Neurosurgery, International University of Health and Welfare, Narita Hospital, Narita City, Japan.
Tatsuya TanakaDepartment of Neurosurgery, International University of Health and Welfare, Narita Hospital, Narita City, Japan.
Takashi AgariDepartment of Neurosurgery, International University of Health and Welfare, Narita Hospital, Narita City, Japan.
Takashi SugawaraDepartment of Neurosurgery, International University of Health and Welfare, Narita Hospital, Narita City, Japan.
Kazuaki ShimojiDepartment of Neurosurgery, International University of Health and Welfare, Narita Hospital, Narita City, Japan.
Eiich SuehiroDepartment of Neurosurgery, International University of Health and Welfare, Narita Hospital, Narita City, Japan.
Kimihiro NakaharaDepartment of Neurosurgery, International University of Health and Welfare, Narita Hospital, Narita City, Japan.
Hiroshi ItokawaDepartment of Neurosurgery, International University of Health and Welfare, Narita Hospital, Narita City, Japan.
Akira MatsunoDepartment of Neurosurgery, International University of Health and Welfare, Narita Hospital, Narita City, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Trigeminal neuralgia (TN) is most commonly caused by neurovascular compression; however, a subset of patients present without identifiable vascular contact, for whom the optimal surgical strategy remains controversial. Methods: Between February 2022 and August 2025, 157 patients underwent microsurgical treatment for TN at our institution. This study represents a retrospective analysis of a prospectively maintained surgical database. Thirty patients without radiological or intraoperative evidence of neurovascular compression were treated with superficial epineurial incision. Pain outcomes were evaluated using the Barrow Neurological Institute (BNI) pain intensity scale, and postoperative complications were assessed. Results: Immediate postoperative pain relief (BNI I-II) was achieved in all patients. At 12 months, 27 (90%) patients maintained favorable outcomes. Recurrence was defined as deterioration to BNI grade III or higher requiring additional medication or reintervention; 3 (10%) patients met this definition. Transient facial numbness occurred in 3 (10%) patients and resolved within 3 months. No permanent dysesthesia, anesthesia dolorosa, or corneal complications were observed. Conclusion: In this exploratory retrospective case series, superficial epineurial incision was feasible and associated with favorable short-term pain control with limited sensory morbidity in carefully selected patients with classical TN without neurovascular compression. Interpretation of these findings should be made in the context of the baseline, and further studies with larger cohorts and longer follow-up are required.

Indexed as

Internal neurolysisMicrovascular decompressionTrigeminal neuralgiaWithout vascular compression

Identifiers

PMID42116890
PMCPMC13157949

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.