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July 1948

TRIGEMINAL TRACTOTOMY: Observations on Forty-Eight Cases

Author Affiliations

From the University of Buffalo School of Medicine and the Buffalo General Hospital.

Arch Surg. 1948;57(1):171-177. doi:10.1001/archsurg.1948.01240020174015

IN 1938 Sjöqvist1 described trigeminal tractotomy, an operation planned to sever the descending spinal tract of the fifth cranial nerve. By this maneuver he was able to relieve patients of facial pain without sacrificing facial touch sensibility. Subsequently others have reported results confirming his conclusions.

Since April 27, 1939, we have performed forty-eight tractotomies, with a 16.6 per cent mortality rate (fig. 1). Thirty-five of the operations were done for the relief of trigeminal neuralgia. The pain involved the first division in 28 cases, was bilateral in 1 and had affected the opposite side after a previous rhizotomy in 6. Two of the 35 patients died, 1 of uremia seven days after operation and 1 after four days of difficult and irregular respiration. Although the operation was attended with no noticeable difficulties, at necropsy the pons and the medulla were edematous, with scattered petechial hemorrhages. This consituted a mortality