Ultrasound-Guided Mandibular Nerve Pulsed Radiofrequency With Adjunct Dexamethasone in Trigeminal Neuralgia: A Retrospective Cohort Study

BACKGROUND: This study aimed to evaluate the clinical outcomes and safety of ultrasound-guided pulsed radiofrequency (PRF) targeting the mandibular nerve (V3) with adjunct low-dose perineural dexamethasone in patients with trigeminal neuralgia (TN). METHODS: We retrospectively analyzed 73 consecutive patients treated between April 2022 and August 2025. The primary outcome was the change in Numeric Rating Scale (NRS) pain scores at 1, 3, and 6 months. Secondary outcomes included functional status assessed by the Short Form-12 Health Survey (SF-12), adverse events, and reintervention rates. RESULTS: The mean NRS decreased from 6.97±0.73 at baseline to 2.22±0.80, 3.07±0.82, and 3.30±1.08 at 1, 3, and 6 months, respectively (all P<0.001). SF-12 scores improved significantly at all time points (P<0.001). The minimal clinically important difference (≥2-point reduction) was achieved in more than 90% of patients. Two patients (2.74%) developed minor hematomas, and no major complications were observed. Reintervention was required in 5.48% of patients. CONCLUSIONS: Ultrasound-guided V3 PRF with adjunct dexamethasone was associated with significant pain reduction and functional improvement, with a favorable safety profile. These findings are observational and require confirmation in controlled prospective studies.