Are peripheral neurectomies of value in the treatment of trigeminal neuralgia? An analysis of new cases and cases involving previous radiofrequency gasserian thermocoagulation

Abstract

The indications, advantages, complications, and benefits of peripheral neurectomy in patients with trigeminal neuralgia were studied in detail in 40 patients treated between 1982 and 1991. Twenty-eight patients had previously received radiofrequency thermocoagulation: peripheral neurectomy was performed for pain recurrence. These patients had excellent or good pain relief for at least 5 years postsurgery. Of the 12 patients who had peripheral neurectomy as their only procedure, seven had an excellent result and five had a good result. Five of the patients had recurrence of pain after 2 years but responded well to a second neurectomy. Elderly patients who experienced pain in the first and second divisions of the trigeminal distributions were the best candidates. Peripheral neurectomy is an effective, safe procedure for elderly patients who suffer from trigeminal neuralgia and have a limited life span.

Neurectomy of the trigeminal nerve branches: Clinical evaluation of an “obsolete” treatment

“…Twice as many operations were carried out on the second branch (63%) compared with the third one (29%), which is in agreement with the literature (Ziccardi et al, 1991(Ziccardi et al, , 1994, while Bagatin and Arko (1984) state an approximately equal number of neurectomies on the second and third branch. In our study, there were no patients with neurectomy performed on the first branch because there were no indications for it, although other authors mention a relatively high frequency of surgical intervention on the first branch (Murali and Rovit, 1996;Perkin, 1999).…”

Percutaneous Balloon Compression for the Treatment of Recurrent Trigeminal Neuralgia: Long-Term Outcome in 29 Patients

“…For example, a reason- ably healthy young to middle-aged person would be offered a more aggressive surgical treatment such as microvascular decompression which has shown a high success rate and long-term pain control [16,19] . By contrast, an older person with multiple medical problems who is at high risk to undergo a microvascular decompression would be offered a simpler treatment modality such as a peripheral neurectomy [22] .…”

“…There are several alternative modalities for the treatment of TN with comparable clinical outcome, recurrence, and complication rates [3,7,8,10,12,13,15,16,[18][19][20][21][22] . Several studies have investigated the clinical outcome of PBC as an initial treatment, and some include a low percentage of patients who were treated initially with a different surgical modality.…”

Классическая Невралгия Тройничного Нерва

“…Отсутствие стойкого положительного эффекта от консерва-тивной терапии вновь способствовало расширению и распро-странению различных деструктивных вмешательств на ветвях ТН и на полулунном узле: неврэктомия, феноловая, гидротермиче-ская, радиочастотная или глицероловая деструкция [54,91,92,106,117,129,196,201,328,370,408]. В мире проводятся масштабные исследования по эффектив-ности других противосудорожных препаратов: окскарбазепин, клоназепам, ламотриджин, вальпроаты, габапентин [197,255,295,304,344,379,384,421].…”