Relationship of the infraorbital nerve and vessels in the pathogenesis of idiopathic trigeminal neuralgia: a theoretical discussion and cadaveric study.

Many etiologies have been postulated to explain the pathogenesis of Trigeminal Neuralgia (TN). Most theories focus on a demyelinating process resulting in ephaptic transmission and recruitment of small pain fibers or a restrictive relationship of the superior cerebellar arteries and the trigeminal nerve roots at the level of the pons which may lead to demyelination. It is postulated that vasodilation or constriction of these vessels in a confined bony canal can create localized regions of demyelination and restrictive relationships creating painful stimuli. It is the purpose of this study to grossly investigate the relationship of the infraorbital nerve and vessels passing through the infraorbital canal to discuss whether their relationship may play a role in the pathogenesis of idiopathic TN. Patterns of relationship have been elucidated and will be described. This preliminary gross anatomical study should set the framework from which to base further microscopic and clinical studies.