Long-term Results of 405 Refractory Trigeminal Neuralgia Surgeries in 256 Patients

Haridas, Arjun; Mathewson, Carleton; Eljamel, Sam

doi:10.1055/s-2008-1077076

Cited by 32 publications

(30 citation statements)

References 26 publications

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“…Excellent results were reported by 76.7% and good results by 10% of the patients. These results were comparable to some recently reported findings [18] . Our data and previous studies suggested that the success of RFT was similar to those of MVD [19] .…”

Section: Discussionsupporting

confidence: 95%

Percutaneous radiofrequency thermocoagulation for the treatment of different types of trigeminal neuralgia: Evaluation of quality of life and outcomes

Huang

et al. 2010

J. Huazhong Univ. Sci. Technol. [Med. Sci.]

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Radiofrequency thermocoagulation (RFT) of the gasserian ganglion is a routine and effective technique for the treatment of classical trigeminal neuralgia (CTN). In this study we compared its efficacy in patients with CTN and atypically symptomatic or mixed trigeminal neuralgia (MTN). Fifty-seven patients were treated with RFT for trigeminal neuralgia from June 2006 to February 2009. Thirty patients had CTN, and 27 had MTN. Outcomes were measured by using the visual analog pain scale (VAS) and patients' reports of quality of life (QOL), medication usage, and complications over a follow-up period of up to 3 years. Our results showed that the patients with MTN were younger, tended to have bilaterial involvement of the first division, and were unresponsive to treatment. All surgeries were completed smoothly. About 86.7% CTN patients and 48.1% MTN patients responded immediately to RFT. The VAS scores were significantly higher in the CTN group than in MTN group (P<0.05). Kaplan-Meier curves showed that 1-year, 2-year, and 3-year pain relief rates were 76.7%, 73.3%, and 73.3% in the CTN group and 46.6%, 41.4%, and 41.4% in the MTN group, respectively. The rates of pain relief for both groups leveled off at 2 years. Complications included numbness, dysesthesia, and anesthesia dolorosa. RFT did not cause any deaths and complications were low. The treatment was very effective for CTN and, to some degrees, effective for MTN. If numbness, dysesthesia, and anesthesia dolorosa are limited to the trigger area, QOL will be greatly improved.

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Section: Discussionsupporting

confidence: 95%

Percutaneous radiofrequency thermocoagulation for the treatment of different types of trigeminal neuralgia: Evaluation of quality of life and outcomes

Huang

et al. 2010

J. Huazhong Univ. Sci. Technol. [Med. Sci.]

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“…50,52,[74][75][76][77][78] Fraioli and colleagues, 36 in comparing outcomes for PBC, RFT, and GR, recommended PBC as the first-line choice for percutaneous rhizotomy given its high efficacy rate and low complication rates. Kouzounias and colleagues 75 examined outcomes after PBC and GR, finding comparable rates of initial pain relief for each procedure as well as comparable times to recurrence.…”

Section: Comparative Treatment Efficacymentioning

confidence: 97%

Percutaneous Procedures for the Treatment of Trigeminal Neuralgia

Wang

Bender

Bettegowda

2016

Neurosurgery Clinics of North America

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“…Other treatment options for iTN include stereotactic radiosurgery using the Gamma Knife, radiofrequency thermal rhizotomy, and botulinum toxin injections at the trigger zone. 4,13,20,21 According to the scientific literature, MVD appears to cause fewer sensory alterations than other treatments, although it is more often related to rare but serious complications. However, to our knowledge, there are no studies comparing these techniques in a prospective design, including complete examination of the orofacial area with detailed sensory and functional quantification.…”

mentioning

confidence: 99%

“…10,15 Microvascular decompression (MVD) is an open surgery that was introduced by Peter Jannetta in 1967. 33 It is considered to have the best long-term results for iTN, with a low rate of recurrence of pain (15%-25% within 3 years) 13,23 and few collateral effects. 1,4,[20][21][22]26 The percutaneous balloon compression (BC) of the trigeminal ganglion was introduced by Mullan and Lichtor in 1983.…”

mentioning

confidence: 99%

Sensory abnormalities and masticatory function after microvascular decompression or balloon compression for trigeminal neuralgia compared with carbamazepine and healthy controls

Ichida

Almeida

Nóbrega

et al. 2015

JNS

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There is a lack of comparative papers regarding the outcomes of neurosurgery in patients with iTN. The objective of this study was to investigate sensory thresholds and masticatory function in 78 patients with iTN who underwent microvascular decompression (MVD) or balloon compression (BC), and compare these treatments with carbamazepine and 30 untreated healthy controls. methods The authors conducted a case-controlled longitudinal study. Patients were referred to 1 of 3 groups: MVD, BC, or carbamazepine. All patients were evaluated before and after treatment with a systematic protocol composed of a clinical orofacial questionnaire, Research Diagnostic Criteria for temporomandibular disorders, Helkimo indices, and a quantitative sensory-testing protocol (gustative, olfactory, cold, warm, touch, vibration, superficial, and deep pain thresholds). results Both MVD and BC were effective at reducing pain intensity (p = 0.012) and carbamazepine doses (p < 0.001). Myofascial and articular complaints decreased in both groups (p < 0.001), but only the patients in the MVD group showed improvement in Helkimo indices (p < 0.003). Patients who underwent MVD also showed an increase in sweet (p = 0.014) and salty (p = 0.003) thresholds. The sour threshold decreased (p = 0.003) and cold and warm thresholds increased (p < 0.001) in patients after MVD and BC, but only the patients who underwent BC had an increase in touch threshold (p < 0.001). coNclusioNs Microvascular decompression and BC resulted in a reduction in myofascial and jaw articular complaints, and the impact on masticatory function according to Helkimo indices was greater after BC than MVD. MVD resulted in more gustative alterations, and both procedures caused impairment in thermal thresholds (warm and cold). However, only BC also affected touch perception. The sensorial and motor deficits after BC need to be included as targets directly associated with the success of the surgery and need to be assessed and relieved as goals in the treatment of iTN.

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Long-term Results of 405 Refractory Trigeminal Neuralgia Surgeries in 256 Patients

Cited by 32 publications

References 26 publications

Percutaneous radiofrequency thermocoagulation for the treatment of different types of trigeminal neuralgia: Evaluation of quality of life and outcomes

Percutaneous radiofrequency thermocoagulation for the treatment of different types of trigeminal neuralgia: Evaluation of quality of life and outcomes

Percutaneous Procedures for the Treatment of Trigeminal Neuralgia

Sensory abnormalities and masticatory function after microvascular decompression or balloon compression for trigeminal neuralgia compared with carbamazepine and healthy controls

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