Long-term Outcome of Computed Tomography–Guided Percutaneous Radiofrequency Thermocoagulation for Classic Trigeminal Neuralgia Patients Older Than 70 Years

Tang, Yue; Jin, Di; Jingjing, Bian; Li, Xuanying; Lai, Guang-Hui; Ni, Jiaxiang

doi:10.1097/scs.0000000000000591

Cited by 28 publications

(45 citation statements)

References 21 publications

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“…The efficacy of RFT at both temperatures is coincident to that in previous studies [28–30] and even better than that reported in several other studies. [21,31,32] Improved efficacy for pain relief in the current study might be associated with the following factors: as opposed to previous reports [4,14,22,33] that have investigated ITN and STN together, we strictly included ITN and excluded STN; we included V2, V3, and V2+V3 for RFT comparison but excluded V1 and V1 TN because RFT at a lower temperature, nerve block, or pulse RFT (PRFT) is required for V1, and thus V1 and V1 TN should be addressed separately. However, V1, V2, and V3 have been investigated together in many studies; RFT parameters were also influential.…”

Section: Discussionmentioning

confidence: 99%

Treatment of bilateral idiopathic trigeminal neuralgia by radiofrequency thermocoagulation at different temperatures

et al. 2016

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Radiofrequency thermocoagulation (RFT) is an effective treatment for trigeminal neuralgia, but consensus regarding an optimal treatment temperature is lacking. While treatment temperatures ranging from 60°C to 95°C have been reported, RFT at too high a temperature is often followed by serious complications, and comparative evaluations of RFT at different temperatures in a single study are rare.This current prospective cohort study was to compare immediate and long-term outcomes of RFT at varying temperatures in patients with bilateral idiopathic trigeminal neuralgia (ITN) of maxillary division of trigeminal nerve (V2), mandibular division of trigeminal nerve (V3), and V2+V3, including pain relief, complications, recurrence rate, and patient satisfaction. From May 2011 to April 2016, 62 consecutive patients with bilateral ITN of V2, V3, and V2+V3 were enrolled in the study. These patients underwent bilateral RFT at 68°C and 75°C, respectively, using the same RF parameters. Side-to-side results, including pain relief, complications, and patient satisfaction, were compared during a 5-year follow-up period.Overall pain relief was satisfactory after RFT. The rate of pain relief after treatment at 75°C was slightly higher than at 68°C (P > 0.05). The pain-free rate was 95.1% at 75°C and 93.5% at 68°C at 1 year, 84.3% and 78.1% at 3 years, and 80.7% and 74.4% at 5 years. There were 10 and 13 cases of recurrence, respectively, and 6 cases of bilateral recurrence. The incidence and severity of complications were greater at 75°C (P < 0.05) than at 68°C, and therefore the patient satisfaction at the higher temperature was lower (P < 0.05).Patients with bilateral ITN who underwent RFT at different temperatures had consistent pain relief after RFT at both 75°C and 68°C, but there were fewer and less severe complications at 68°C, which was accompanied by greater patient satisfaction. This suggests that RFT at lower temperatures may be preferable, and that a temperature of 68°C can be recommended.

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Section: Discussionmentioning

confidence: 99%

Treatment of bilateral idiopathic trigeminal neuralgia by radiofrequency thermocoagulation at different temperatures

et al. 2016

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“…Facial numbness classification (grade I to IV) was recorded before the second MRI scanning. [2] If any patient got pain recurrence or did not receive pain relief during the following 6 months after the PRT procedure, the VAS would also be recorded. The Research Ethics Committee of Xuanwu Hospital approved this study and written informed consent was obtained from each participant.…”

Section: Methodsmentioning

confidence: 99%

“…[2,14] The puncture of gasserian ganglion was according to the Hartel anterior route. The best puncture approach to the oval foreman and the corresponding skin insertion point was determined by CT scanning.…”

Section: Methodsmentioning

confidence: 99%

“…Despite advances in the therapy of trigeminal neuralgia (TN), such as microvascular decompression (MVD) Gamma Knife radiosurgery (GKRS) and percutaneous radiofrequency thermocoagulation (PRT), some 5% to 10% of patients may not achieve immediate pain relief after initial surgeries, and recurrence rates rise up to 50% at 10 years, leading to significant personal, social, and economic burden. [1,2] Development of more effective treatment strategies for this neuropathic pain disorder will require better knowledge of its neurobiological underpinnings.…”

Section: Introductionmentioning

confidence: 99%

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Alternation of regional homogeneity in trigeminal neuralgia after percutaneous radiofrequency thermocoagulation

Dou

Xue-yi²,

Yang³

et al. 2016

Medicine

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We used resting-state fMRI to investigate regional homogeneity (ReHo) changes in patients with TN before and after PRT procedure, and to speculate about its possible mechanisms.Thirty-one TN patients underwent the PRT procedure had MRI scans just before and 6 months after surgery. The anatomical and resting-state functional images were all acquired. Patients’ visual analog scales (VAS) scores, facial numbness, and disease duration were also recorded. Voxel-wise ReHo analysis was performed to detect the altered regional clusters after surgery. The correlations between the mean ReHo values of each significant cluster and clinical variables were examined.Compared with presurgical condition, patients after the PRT procedure showed a significant ReHo value increases in the right fusiform gyrus (FG) and bilateral anterior cingulate cortex (ACC), but decreases in the left inferior parietal lobule (IPL), right calcarine, right middle temporal gyrus (MTG), left postcentral gyrus (PoCG), and left insula. We demonstrated a positive correlation between ReHo in the left PoCG and VAS scores, a negative correlation between pre-surgical ReHo in the right MTG and VAS changes (ΔVAS).Alterations of ReHo post-surgical were found in several regions, which are related to sensory, affective, and emotional processes. The MTG may be a specific area that is associated with analgesic efficiency of PRT procedure.

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“…Patients with typical TN usually respond to RF ablation [7][8][9][10][11][12][13]. Yet, limited studies have addressed the efficacy of RF in cases with atypical trigeminal neuralgia [14,15].…”

Section: Introductionmentioning

confidence: 99%

Radiofrequency thermocoagulation in cases of atypical trigeminal neuralgia: a retrospective study

Akbaş

Salem

Emara

et al. 2019

Egypt J Neurol Psychiatry Neurosurg

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Background: Trigeminal neuralgia (TN) is the most common cause of neuropathic facial pain. Atypical TN are usually refractory to conventional medical treatments and the standard microvascular decompression surgeries that lead to marked negative impact on the patient's quality of life. Objective: The aim of this study is to examine the efficacy and safety of radiofrequency (RF) ablation in cases with atypical TN that did not respond to standard medical treatments. Methods: Our study included 19 consecutive patients with refractory atypical TN for more than 6 months. Neurological examination and MRI brain did not reveal any significant correlated signs. RF thermocoagulation was performed under fluoroscopy guidance. Collected data included preoperative conditions, pre-and post-procedure visual analog scale (VAS) score, and complications. Patients were followed up for a period of 1-year duration to evaluate the long-term efficiency of the procedure. Results: A total of 19 patients were recruited into the study (56.32 ± 13.48 years, 21% males, 79% females). Females outnumbered males (15 female patients, 79%) versus (4 male patients, 21%). There was more than 50% improvement in VAS score (16 patients, 79% versus 3 patients, 21%) (p < 0.05). Age was the only statistically significant factor were more elderly patients showed better improvement regarding VAS score (p < 0.05). Conclusions: Radiofrequency thermocoagulation is an effective and relatively safe procedure for alleviating atypical facial pain.

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Long-term Outcome of Computed Tomography–Guided Percutaneous Radiofrequency Thermocoagulation for Classic Trigeminal Neuralgia Patients Older Than 70 Years

Cited by 28 publications

References 21 publications

Treatment of bilateral idiopathic trigeminal neuralgia by radiofrequency thermocoagulation at different temperatures

Treatment of bilateral idiopathic trigeminal neuralgia by radiofrequency thermocoagulation at different temperatures

Alternation of regional homogeneity in trigeminal neuralgia after percutaneous radiofrequency thermocoagulation

Radiofrequency thermocoagulation in cases of atypical trigeminal neuralgia: a retrospective study

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