ObjectiveTo evaluate risk factors associated with recurrence after radiofrequency thermocoagulation (RFT) of the gasserian ganglion among patients with ophthalmic trigeminal neuralgia (TN) and prognostic factors in terms of recurrence‐free survival (RFS) during a long‐term follow‐up.MethodsFrom January 2005 to December 2017, 300 patients with ophthalmic TN underwent RFT. A retrospective analysis of 14‐year outcomes was performed. Kaplan‐Meier analysis was used for RFS after the procedure. Univariate and multivariate Cox regression analyses were performed to identify risk factors for pain recurrence.ResultsThe initial effective rate of RFT for ophthalmic TN was 92%. The mean follow‐up time was 77.38 ± 43.24 months. The cumulative probability of RFS was 86.94% at 1 year, 80.03% at 2 years, 77.27% at 3 years, 74.01% at 5 years, and 59.92% at 10 years after RFT. The mean duration of RFS was 114.67 months (95% confidence interval [CI] 106.27 to 123.06 months). In multivariate analysis, atypical pain (hazard ratio [HR] = 2.831, 95% CI 1.759 to 4.554, P < 0.001) and mild facial hypesthesia (HR = 2.540, 95% CI 1.309 to 4.931, P = 0.006) before RFT were independently associated with pain recurrence. Patients with a prognostic index (PI) > 1.27 were at high risk for pain recurrence. Major complications included troublesome dysesthesia (0.7%), keratitis (10.9%), diplopia (0.4%), facial paresthesia (6.2%), and masseter weakness (12.7%). Masseter weakness was more common in patients with V3 branch involvement. Three patients lost their sight due to keratitis.ConclusionOur study investigated long‐term outcomes and complications of RFT for ophthalmic TN. Patients at high risk for pain recurrence were identified, which might provide a basis for clinical decision making before RFT.

& AbstractObjectives: In this study we aimed to identify specific factors predicting successful outcomes after percutaneous radiofrequency thermocoagulation (RFT) for idiopathic trigeminal neuralgia (ITN) and risk factors that were associated with inferior outcomes. Methods: We retrospectively reviewed our cohort of 1,624 patients who underwent RFT for trigeminal neuralgia between January 2000 and December 2017. Demographic and clinical data including age, gender, disease duration, affected side, baseline pain score, pain distribution, history of previous surgical intervention, and pain characteristics were collected and evaluated for their association with outcome using univariate and multivariate logistic regression analysis. Results: 78.1% of patients experienced a successful outcome of RFT for ITN as predefined criteria. Pain characteristics and history of surgical treatment were significant predictors associated with successful outcomes in regression analysis. Multivariate analysis identified provoked episodic pain at diagnosis (odds ratio [OR] = 23.629, 95% confidence interval [CI]: 16.316 to 34.219, P = 0.010), mixed pain (OR = 8.394, 95% CI: 5.951 to 11.840, P = 0.011), and no history of surgical treatment (OR = 2.189, 95% CI: 1.411 to 3.396, P = 0.019) as independent predictors for successful RFT outcome. Conclusion: Presence of provoked episodic pain and mixed pain were significantly associated with successful outcome of RFT for ITN. Moreover, patients with ITN who underwent RFT for the first time were more likely to benefit from successful outcome. These findings should be considered when managing ITN with RFT to improve the likelihood of a successful outcome. &