Radiofrequency Ablation for Craniofacial Pain Syndromes

Orhurhu, Vwaire; Sidharthan, Shawn; Roberts, J; Karri, Jay; Umukoro, Nelly; Hagedorn, Jonathan M; Odonkor, Charles A.; Abd‐Elsayed, Alaa

doi:10.1016/j.pmr.2021.05.003

Cited by 3 publications

(7 citation statements)

References 44 publications

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“…The employment of neuronavigation was discussed in various studies. 21 RFTR, when used with image guidance, was reported to have better longer long-term pain relief and lower pain recurrence. 68 Yet, Luo et al 69 found otherwise, but noting that the voltage and electric field intensity were significantly lower in the patients with ineffective treatment outcomes.…”

Section: Adverse Outcomes and Complicationsmentioning

confidence: 94%

“…20 Even though conflicting pain relief efficacy and complication development from the 2 treatment modalities have been reported in studies, [63][64][65] a recent study by Abd-Elsayed et al 66 using a novel transcoronoid approach PRF has reported pain improvement in patients with TN without complication development, proposing the possibility of satisfactory pain relief efficacy and safety profile of PRF when no cannulation of FO is performed. Meanwhile, in other systematic reviews, 21,67 combined RFTR/PRF therapy has been shown to obtain the maximal pain control in patients with facial pain when compared to RFTR or PRF alone. Combined RFTR/PRF therapy also resulted in immediate pain relief after the procedure, the highest patient satisfaction at postoperative 1 month and 6 months, and the lowest complication rates.…”

Section: Adverse Outcomes and Complicationsmentioning

confidence: 98%

“…11,12 Microvascular decompression, 13 stereotactic radiosurgery, 14 and percutaneous rhizotomy procedures [15][16][17][18][19] have been proposed. Based on systematic review, there is evidence to suggest that radiofrequency thermocoagulation rhizotomy (RFTR) yields the most promising long-term results with an initial pain relief rate above 95% 20,21 and 10-year pain recurrence rates range of 7.8% to 25%. 22,23 Percutaneous trigeminal rhizotomies require the cannulation of the foramen ovale (FO) that relies on superficial facial landmarks as references.…”

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confidence: 99%

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Neuronavigation-Guided Percutaneous Rhizotomies to Trigeminal Neuralgia

Wu,

Cheung,

Leung

2024

The Clinical Journal of Pain

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Objective: Neuronavigation improves intraoperative visualisation to the cranial structures, which is valuable in percutaneous surgical treatments for trigeminal neuralgia (TN) patients who are refractory to pharmacotherapy or reluctant to receive open surgery. The objective of this review is to evaluate the available neuronavigation-guided percutaneous surgical treatment modalities with cannulation of foramen ovale to TN, and their relative benefits and limitations. Methods: This review was conducted based on the PRISMA statement. An initial search was performed on electronic databases, followed by manual and reference searches. Study and patient characteristics, rhizotomy procedure and neuronavigation details, and treatment outcomes (initial pain relief and pain recurrence within 2 years, success rate of forman ovale cannulation, and complications) were evaluated. Risk of bias was assessed with a quality assessment based on the ROBINS-I tools. Results: Ten studies (491 operations, 403 subjects) were analysed. Three percutaneous trigeminal rhizotomy modalities identified were radiofrequency thermocoagulation rhizotomy (RFTR), percutaneous balloon compression (PBC), glycerol rhizotomy. iCT/MRI RFTR had the highest initial pain relief rate of 97.0%. Success rate of FO cannulation ranged from 92.3% to 100% under neuronavigation. Facial hypoesthesia and masticatory muscle weakness were the most reported complications. Discussion: Neuronavigation-guided percutaneous trigeminal rhizotomies showed possible superior pain relief outcomes to that of conventional rhizotomies in TN, with the benefits of radiation reduction and lower complication development rates. Limitations of neuronavigation remain its high cost and limited availability. Higher-quality prospective studies and randomized clinical trials of neuronavigation-guided percutaneous trigeminal rhizotomy were lacking.

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Section: Adverse Outcomes and Complicationsmentioning

confidence: 94%

Section: Adverse Outcomes and Complicationsmentioning

confidence: 98%

mentioning

confidence: 99%

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Neuronavigation-Guided Percutaneous Rhizotomies to Trigeminal Neuralgia

Wu,

Cheung,

Leung

2024

The Clinical Journal of Pain

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“…Nonetheless, owing to the limited efficacy and the side effects of pharmacological therapy, invasive methods such as nerve blocks, neurolytic procedures, and surgical procedures have been employed. 5 Radiofrequency (RF) therapy to the SPG has been tried in patients who remain unresponsive to conservative treatments. However, only a limited number of studies have investigated the efficacy of this intervention.…”

Section: Introductionmentioning

confidence: 99%

“…While this is the most significant benefit of PRF, PRF is generally inferior to CRF in terms of success of pain relief. 5 The goal of this study was to investigate the efficacy and safety of SPG-PRF treatment in 26 patients with ECH.…”

Section: Introductionmentioning

confidence: 99%

Results of sphenopalatine ganglion pulsed radio- frequency treatment in patients suffering from episodic cluster headache

Akkemik¹,

Aliyev²,

Özgencil³

2023

NeuroAsia

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Background & Objective: The aim of this study was to investigate the short- to medium-term effects of pulsed radiofrequency (PRF) of the sphenopalatine ganglion on episodic cluster headache. Methods: This is a retrospective observational study, 26 patients who underwent PRF of the sphenopalatine ganglion were retrospectively evaluated. The Visual Analogue Scale (VAS) score, number of headache attacks per week, autonomic symptoms and medication use were recorded at 1, 3 and 6 months after the procedure. Results: The mean VAS scores were significantly lower at the 1-, 3-, and 6-month evaluations compared with pre-procedure values (P < 0.001). At the 6th month after the procedure, the proportion of subjects who completely stopped using medications was 26.9%, and the proportion with a decrease in autonomic symptoms was 61.5%. No complications were encountered as a result of the procedure. Conclusion: The application of PRF to the sphenopalatine ganglion is an effective and safe treatment option for episodic cluster headache in the short to medium term.

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Molecular Process Of Trigeminal Neuralgia, its Pharmacologic, and Comparison of Surgical Treatment Options with Outcomes

Shah,

Ikram,

Khan

2024

Preprint

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According to published descriptions, one of the most incapacitating forms of orofacial pain is trigeminal neuralgia (TN). At its core, trigeminal neuropathic pain (TN) is still a clinical diagnostic that has to be differentiated from other forms of TN and face pain linked to other neuralgias or headache disorders. Imaging can only help with the cause of the pain, whether it’s a vascular origin or not. It is becoming more and more evident that there is no one-size-fits-all medication or surgical procedure that can effectively treat every patient with trigeminal neuralgia (TN). This is probably because TN is a diverse collection of conditions that all present with face discomfort. Medical therapy using anticonvulsants like carbamazepine is still the first-line treatment for TN. If this doesn't work for the patient, surgical treatments are available. Microvascular decompression is often a safe, efficient operation with results that are both rapid and long-lasting. Patients who may benefit from percutaneous techniques such as radiofrequency ablation, glycerol ablation, balloon compression, or a combination, include those who cannot undergo general anesthesia or whose medical conditions prohibit a suboccipital craniectomy. Radiosurgery may be a great option for patients with bleeding diathesis brought on by blood-thinning medications who are not eligible for invasive procedures or who do not want to undergo open surgical procedures, as long as the patient is aware that achieving maximum pain relief may take several months. In conclusion, peripheral neurectomies persist in offering a low-cost and resource-saving substitute for pain management to those residing in areas with restricted financial and healthcare resources. In the end, developing a better understanding of the molecular processes behind trigeminal neuralgia will lead to new, less intrusive, and more effective treatments.

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Radiofrequency Ablation for Craniofacial Pain Syndromes

Cited by 3 publications

References 44 publications

Neuronavigation-Guided Percutaneous Rhizotomies to Trigeminal Neuralgia

Neuronavigation-Guided Percutaneous Rhizotomies to Trigeminal Neuralgia

Results of sphenopalatine ganglion pulsed radio- frequency treatment in patients suffering from episodic cluster headache

Molecular Process Of Trigeminal Neuralgia, its Pharmacologic, and Comparison of Surgical Treatment Options with Outcomes

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