Comparison of nerve combing and percutaneous radiofrequency thermocoagulation in the treatment for idiopathic trigeminal neuralgia

Zhou, Xinming; Liu, Yiqing; Yue, Zhiyong; Luan, Deheng; Zhao, Hong; Han, Jianyong

doi:10.1016/j.bjorl.2015.11.006

Cited by 27 publications

(16 citation statements)

References 19 publications

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“…There was a high proportion of patients with CSF return, the incidence was higher than for other studies (8% to 17.6%). [ 29 , 44 ] The difference might be accounted for by the technique used to perform CRF for V1 TN. The puncture needle must be delivered as deeply as possible after arriving at the trigeminal ganglion via the foramen ovale, in order to test V1.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of continuous radiofrequency thermocoagulation plus pulsed radiofrequency for treatment of V1 trigeminal neuralgia

Yao¹,

Hong²,

Zhu³

et al. 2016

Medicine

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Patients may develop serious eye complications after continuous radiofrequency thermocoagulation (CRF) for V1 (ophthalmic division) trigeminal neuralgia (TN) at a higher temperature. Therefore, the temperature of clinical CRF for V1 TN has long been disputed, but there have few reports been found about how to achieve satisfactory pain relief, reduce the incidence rates of complications, and shorten the recovery time after CRF for V1 TN.To observe whether pulsed radiofrequency (PRF) can lead to increased rate in pain relief, reduced rate of complications, or shortened recovery time after CRF is used to treat V1 idiopathic trigeminal neuralgia (ITN).The prospective cohort study enrolled 56 patients with V1 ITN from May 2012 to April 2015. The patients were randomized into 2 treatment groups as follows: CRF only (group A, n = 28) and CRF plus PRF (group B, n = 28). The patients were followed 3 years up for pain relief, complications, and health-related quality of life (HRQoL).All the patients in either group achieved satisfactory pain relief at discharge. After treatment, patients completely pain free in group A and group B accounted for 81.6%, 92.0% at 1 year, 68.4%, 92.0% at 2 years, and 68.4%, 83.6% at 3 years, respectively. The pain relief rate was higher in group B patients than in group A, but the difference was not statistically significant. During the follow-up period, 9 (32.1%) patients in group A and 2 (7.1%) patients in group B developed recurrence (P < 0.05). Eleven patients in group A occurred corneal hypoesthesia and with recovery time was 11.9 ± 7.5 (4–18) months versus 3 patients in group B with recovery time was 3.4 ± 2.5 (2–6) months, the differences of incidence rate and recovery times were all significant (P < 0.05) between groups A and B. The mean scores of HRQoL in group B patients were higher than that in group A patients (P < 0.05).PRF after CRF results in decreased recurrence of V1 TN, reduced numbers of corneal hypoesthesia, shortened recovery time, and increased HRQoL scores. Its clinical use is recommended.

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Section: Discussionmentioning

confidence: 99%

Efficacy and safety of continuous radiofrequency thermocoagulation plus pulsed radiofrequency for treatment of V1 trigeminal neuralgia

Yao¹,

Hong²,

Zhu³

et al. 2016

Medicine

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“…Ko et al reported that patients treated with internal neurolysis experienced numbness, but the numbness did not obviously affect their quality of life (20). Gao et al also reported that MVD and LNS resulted in almost complete pain relief and reduction of the electrical excitability that was being produced by abnormal afferent trigeminal fibers, but causing partial injury to sensory nerves (18)(19)(20)36). During our procedure, we found that the operative route was full of arachnoid thickening and adhesions.…”

Section: Follow-up and Outcome Assessmentsmentioning

confidence: 57%

Effects of microvascular decompression plus longitudinal nerve sectioning on recurrent trigeminal neuralgia and investigations of postoperative recurrence causes

Luo

Cheng²,

Guo³

et al. 2018

Turkish Neurosurgery

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AIM:To investigate the causes of recurrent trigeminal neuralgia (RTN) and to evaluate the efficacy of microvascular decompression (MVD) plus longitudinal nerve sectioning (LNS) or LNS only for RTN patients who have undergone multiple procedures. MATERIAL and METHODS:Twenty one patients underwent MVD plus LNS or LNS only at our institute from June 2008 to December 2014. The patients were retrospectively reviewed and analyzed. The following data were collected: age, sex , treatment before surgery, pain severity and distribution, findings during surgery, immediate postoperative BNI (Barrow Neurological Institute score system), final follow-up BNI, complications and associated comorbidities. RESULTS:Vascular compression, arachnoid adhesion and Teflon granulomas were the primary causes of RTN. After MVD plus LNS or LNS only treatments, almost all patients (19/21, 90.5%) reported pain relief after 36.1 months. Of these patients, 15 patients (71.4%) reported being pain-free (BNI score I) and 4 patients (19.1%) reported pain relief (BNI II-III). Two patients reported a pain level of BNI IV. However, almost all patients were left with some degree of numbness. CONCLUSION:This study certified that vascular compression, arachnoid adhesion and Teflon granulomas were the reasons for RTN. MVD plus LNS or LNS only were both feasible therapeutic options, with good probabilities of success, especially after multiple neurodestructive procedures.

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“…The protein of small nerve fibers (Aδ-and C-type fibers) for pain transmission is coagulated and denatured (12). The action potential is hindered, and the purpose of analgesia is achieved (13). Therefore, the temperature is vital in achieving efficacy and lowering recurrence rate after thermal coagulation.…”

Section: Discussionmentioning

confidence: 99%

Combination of Pulsed Radiofrequency with Continuous Radiofrequency Thermocoagulation at Low Temperature Improves Efficacy and Safety in V2/V3 Primary Trigeminal Neuralgia

Ding

Hong

et al. 2018

Pain Phys

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Background: Primary trigeminal neuralgia (TN) is a common clinical refractory neuralgia. Severe pain is experienced during episodes, severely impacting the patient’s quality of life. Long-term suffering from the disease can lead to anxiety, depression, and even suicide. The pathological processes involved in TN are complex, the mechanisms of pathogenesis are unknown, and effective treatment is lacking. Objective: This study aimed to assess the efficacy and safety of computed tomography (CT)- guided pulsed radiofrequency (PRF) combined with low-temperature continuous radiofrequency (CRF) thermocoagulation in V2/V3 primary trigeminal neuralgia. Study Design: This research used a retrospective comparative study design. Setting: The research took place at Shengjing Hospital of China Medical University. Methods: A total of 80 hospitalized patients with TN were selected between January 2014 and December 2015 and randomly assigned to 2 groups differentiated by therapeutic method: CRF (CRF group, n = 40) and PRF + CRF (PCRF group, n = 40). Radiofrequency therapy was performed under the guidance of CT. Follow-up measures assessed preoperative conditions, pain remission, complications and side effects, recovery time, and recurrence rate over the 2 years following the surgery. Results: The Visual Analog Scale (VAS) scores decreased in both groups after surgery. After one month, the decrease in the VAS score in the PCRF group was more apparent, and this difference was maintained for 2 years. The total efficiency rates in the CRF and PCRF groups were 85% and 97.5%, respectively, at 6 months, 1 year, and 2 years post-surgery. The differences in total efficiency rate of pain between the 2 groups at 6 months, 1 year, and 2 years were statistically significant. Recovery times in the PCRF group were shorter than those in the CRF group. Specifically, recovery times for facial numbness in the CRF and PCRF groups were 3.12 ± 1.21 months and 2.23 ± 1.02 months, respectively. Recovery times for masticatory muscle weakness were 4.33 ± 1.54 months and 3.42 ± 0.98 months, respectively. Limitations: This study is limited by being a retrospective study, and by having a relatively small sample size from a single center. Conclusions: CT-guided PRF combined with low-temperature CRF thermocoagulation for treating V2/V3 primary TN effectively relieves pain, increases late-stage pain remission rate, reduces complications, and reduces the rate of recurrence. Key words: Complication, continuous radiofrequency thermocoagulation, pulsed radiofrequency, recurrence rate, trigeminal neuralgia, Visual Analog Scale

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Comparison of nerve combing and percutaneous radiofrequency thermocoagulation in the treatment for idiopathic trigeminal neuralgia

Abstract: Nerve combing and RF are both satisfactory treatment strategies for patients with ITN. Because of the higher risk of sensory morbidity and surgical risk as open surgery, RF is preferred as the recommended procedure for patients with ITN.

Cited by 27 publications

References 19 publications

Efficacy and safety of continuous radiofrequency thermocoagulation plus pulsed radiofrequency for treatment of V1 trigeminal neuralgia

Efficacy and safety of continuous radiofrequency thermocoagulation plus pulsed radiofrequency for treatment of V1 trigeminal neuralgia

Effects of microvascular decompression plus longitudinal nerve sectioning on recurrent trigeminal neuralgia and investigations of postoperative recurrence causes

Combination of Pulsed Radiofrequency with Continuous Radiofrequency Thermocoagulation at Low Temperature Improves Efficacy and Safety in V2/V3 Primary Trigeminal Neuralgia

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