12.1. Classification and Anatomy
12.1.1. Classification
In Oral and Maxillofacial Surgery, lesions of nerves in the face and jaws area more often develop as the pain syndrome of cranial nerves. In accordance with the ICD-10, lesions of cranial nerves, nerve roots and plexus are attributed to the class Deseases of the nervous system.
Chapter VI. Diseases of the nervous system (G00-G99).
- G50-G59 Damages of several nerves, nerve roots and plexus.
- G50 Disorders of trigeminal nerve.
- G50.0 Trigeminal neuralgia.
- G50.1 Atypical facial pain.
- G50.8 Other disorders of trigeminal nerve.
- G50.9 Disorder of trigeminal nerve, unspecified.
- G51 Facial nerve disorders.
- G52 Disorders of other cranial nerves.
- G52.1 Disorders of glossopharyngeal nerve.
- G52.3 Disorders of hypoglossal nerve.
There are quite a few synonyms used to refer to various cranial nerve lesions that are not found in the ICD-10. In neurology, facial pain is considered to be a multifactorial process, which became the basis for the creation of many classifications, among which the most logical classifications were proposed by V.A. Karlov, O.N. Savitskaya (1990) and A.V. Stepanchenko (2001). In this regard, in the literature, in addition to the term "trigeminal neuralgia", one can find such terms as “vegetative prosopalgia”, “glossalgia”, “neuropathy”, “neuritis”, “stomalgia”, etc.
Depending on etiology and pathogenesis, there are somatogenic and neurogenic lesions of cranial nerves.
- Somatogenic lesions are associated with diseases of the bones of the facial part of the skull, including the jaws, as well as teeth, oral mucosa and ENT organs. The development of pain syndrome can be caused by an inflammatory process in the jaws of odontogenic and non-odontogenic origin, tumors, trauma. There may also be reflected lesions of the cranial nerves in diseases of the internal organs.
- Neurogenic facial pain can be typical or atypical.
- Manifestations of typical lesions are represented by paroxysmal neuralgia of the cranial nerves: trigeminal, lingual-pharyngeal and upperlaryngeal.
- Manifestations of atypical lesions are the vegetative-vascular disorders in cranial neuropathy, intracranial processes and other diseases of the central nervous system (e.g. atherosclerosis, essential hypertension), especially in patients of elderly group.