Radiofrequency thermoablation of the peripheral branches of trigeminal nerve versus the Gasserian ganglion for treating idiopathic trigeminal neuralgia: A systematic review and meta-analysis

Abduhamid, Ahmed S; Alomari, Mohammed S.; Ghaddaf, Abdullah A.; Mullah, Abdullah N; Alqrni, Ali; Haider, Mohamed

doi:10.1016/j.jocn.2022.08.005

Cited by 5 publications

(8 citation statements)

References 37 publications

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“…Although major complications may follow MVD (including severe gait disturbances due to cerebellar brainstem ischemia related to vascular spasm from manipulation, trochlear nerve palsy, facial nerve palsy, loss of hearing, permanent TGN sensory disturbances, and even death), however, in an experienced hand, MVD has a low morbidity and mortality rates. 17,20,[35][36][37] No major morbidity or mortality occurred in the present study with MVD, except for a patient who developed pseudomeningocele that was managed conservatively by application of a lumbar drain and a patient who developed tinnitus and mild hearing loss.…”

Section: Discussionmentioning

confidence: 99%

Microvascular Decompression versus Radiofrequency Ablation in Trigeminal Neuralgia of the Maxillary and Mandibular Divisions

Habib,

Ellakany,

Elnoamany

et al. 2024

Asian J Neurosurg

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Background Although medical treatment is the mainstay of therapy, in trigeminal neuralgia (TN), patients failing to respond to it make them candidates to ablative or nonablative procedures. Objective The aim of this study was to compare the outcome of Microvascular decompression (MVD) and radiofrequency (RF) thermocoagulation in the management of TN affecting the mandibular and maxillary divisions. Methods Retrospective analysis of the data of 40 patients suffering from intractable classical TN affecting the maxillary or mandibular divisions or both was carried out. Twenty patients were operated upon by MVD of the trigeminal nerve; and 20 had RF ablation of the maxillary or mandibular divisions of the trigeminal nerve or both. Results In MVD the overall successful outcome was achieved in 16 patients (80%), while the failure was in 4 patients (20%) of which 3 had a fair outcome and 1 patient had a poor outcome. Whereas in RF the overall successful outcome was achieved in 17 patients (85%), while the failure was in 3 patients (15%) of which 2 had a fair outcome and 1 patient had a poor outcome. Outcome was insignificantly different between both groups (p-value 0.806). Conclusion MVD and RF ablation represent safe and efficacious surgical choices for addressing TN that encompasses both the mandibular and maxillary divisions. Long-term follow-up studies demonstrate that MVD consistently yields favorable outcomes, establishing it as the preferred primary surgical technique, unless contraindicated by the patient's general health and specific needs.

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Section: Discussionmentioning

confidence: 99%

Microvascular Decompression versus Radiofrequency Ablation in Trigeminal Neuralgia of the Maxillary and Mandibular Divisions

Habib,

Ellakany,

Elnoamany

et al. 2024

Asian J Neurosurg

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“…In a systemic review and meta-analysis of five studies on RF ablation in idiopathic TN, RF ablation of the peripheral nerves showed a non-significantly higher immediate effect rate and a lower association with complications. RF ablation of the Gasserian ganglion showed similar pain relief with a lower recurrence rate but was associated with masticatory weakness [ 43 ]. The Gasserian ganglion contains cell bodies (pseudomotor neurons), whereas the peripheral nerves contain Schwann cells, which have a higher capacity for repair than cell bodies.…”

Section: Interventional Treatmentsmentioning

confidence: 99%

“…The Gasserian ganglion contains cell bodies (pseudomotor neurons), whereas the peripheral nerves contain Schwann cells, which have a higher capacity for repair than cell bodies. Therefore, the pathway damaged by RF ablation of the peripheral nerves can be repaired and reformed to transmit pain, leading to recurrence [ 43 ].…”

Section: Interventional Treatmentsmentioning

confidence: 99%

“…The Gasserian ganglion is the most commonly used target for the diagnosis and treatment of TN [ 44 ]. The first technique for accessing the Gasserian ganglion was described by Hartel in 1910, and the concept of RF ablation was introduced in 1975 [ 43 ]. Gasserian ganglion blocks with local anesthetics are used as prognostic blocks before subjecting patients to chemical neurolysis or RF ablation.…”

Section: Interventional Treatmentsmentioning

confidence: 99%

“…RF ablation of the Gasserian ganglion offers the highest rate of complete pain relief in patients with high surgical risk [ 42 ]. In one study, single RF ablation of the Gasserian ganglion showed complete pain relief in 57.7% of patients at 60 months and in 42.2% at 180 months [ 43 ]. However, the evidence of safety is insufficient owing to the requirement of experienced technical skills and the use of neurodestructive modalities.…”

Section: Interventional Treatmentsmentioning

confidence: 99%

See 2 more Smart Citations

Non-Surgical Treatments of Trigeminal Neuralgia from the Perspective of a Pain Physician: A Narrative Review

Lee,

et al. 2023

Biomedicines

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Trigeminal neuralgia (TN) is a unilateral disorder characterized by electric shock-like pain, abrupt onset and termination, and limited to one or more branches of the trigeminal nerve. Various therapeutic modalities for TN have been introduced. We searched for literature indexed in PubMed, Medline, and the National Library of Medicine and reviewed all relevant articles on non-surgical treatments for TN. Published studies were reviewed with no restrictions on date; reviews, clinical trials, animal studies, retrospective studies, and cases were included. Carbamazepine and oxcarbazepine are the recommended first-line pharmacotherapies. Interventional treatments should be considered when pharmacotherapy is insufficient or withdrawn because of adverse effects.

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The long-term outcome of CT-guided radiofrequency ablation of the peripheral branches of the trigeminal nerve in trigeminal neuralgia

Huang,

Liu,

Huang

et al. 2024

Neurosurg Rev

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Radiofrequency thermoablation of the peripheral branches of trigeminal nerve versus the Gasserian ganglion for treating idiopathic trigeminal neuralgia: A systematic review and meta-analysis

Cited by 5 publications

References 37 publications

Microvascular Decompression versus Radiofrequency Ablation in Trigeminal Neuralgia of the Maxillary and Mandibular Divisions

Microvascular Decompression versus Radiofrequency Ablation in Trigeminal Neuralgia of the Maxillary and Mandibular Divisions

Non-Surgical Treatments of Trigeminal Neuralgia from the Perspective of a Pain Physician: A Narrative Review

The long-term outcome of CT-guided radiofrequency ablation of the peripheral branches of the trigeminal nerve in trigeminal neuralgia

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