• Peter Ashman, Max Ward, Michael Umanoff, and Boris Paskhover.
• Department of Otolaryngology-Head and Neck Surgery, Newark, New Jersey, USA.
• World Neurosurg. 2018 Oct 1; 118: 193-196.

BackgroundTrigeminal neuralgia (TN) is a chronic orofacial pain syndrome that presents with debilitating shooting pains in the V3 nerve distribution. The condition is traditionally responsive to anticonvulsant therapy; however, cases that become refractory to medications often require surgical intervention.Case DescriptionWe present a case of TN that was treated with minimally invasive trigeminal ablation. The patient presented with a 6-year history of TN that had been resistant to medical management. The patient opted for minimally invasive management, refused stereotactic radiosurgery, and was treated using the minimally invasive trigeminal ablation approach. At 16 weeks postoperatively, the patient reported complete alleviation of pain with minimal sensorineural numbness.ConclusionsThe endoscopic approach allows for precise targeting through visual guidance, which is ideal in patients undergoing neuroablation for pain within specific nerve distributions. This is the first documented case of an endoscopic minimally invasive transoral approach toward ablative TN management.Copyright © 2018 Elsevier Inc. All rights reserved.

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