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Objective To investigate the clinical effect of precise percutaneous radiofrequency ablation of semilunar ganglion through fo -ramen ovale under the three-dimensional CT for the treatment of trigeminal neuralgia .Methods A total of 80 patients with primary trigeminal neuralgia in our hospital from August 2013 to December 2015 were selected,and they were randomly divided into two groups with 40 cases in each group .The control group was implemented blind detective radiofrequency ablation ,while the observation group was carried out under the three-dimensional CT positioning radiofrequency ablation .All the patients were followed up for 3 months after treatment .Compared the overall clinical results , and recorded the time of targeting the trigeminal nerve and the complications within 1 week after treatment between the two groups.The pain condition at different time points (before treatment,1 week and 3 months after treatment) between the two groups were com-pared.Results The positioning time of observation group was shorter than that of the control group ,the difference was significant (P<0.05). The VAS score of the observation group 1 week and 3 months after surgery was lower than the control group ,the difference was significant (P<0.05).The ratio of masticatory muscle weakness ,hypoacusis,facial swelling and congestion and corneal anesthesia of the observation group within 1 week postoperatively were lower than those of the control group ,the difference was significant (P<0.05).The effective rate of the observation group was higher than that of the control group ,the difference was significant (P<0.05).Conclusion Percutaneous radiofre-quency ablation of semilunar ganglion through foramen ovale under the three -dimensional CT for the treatment of trigeminal neuralgia has the advantages of more accurate positioning of the foramen ovale ,shorter operation time , and less complications ,which can relieve the pain of pa-tients and improve the overall clinical effect .
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Trigeminal trophic syndrome is a rare condition resulting from self-manipulation of the skin after a peripheral or central injury to the trigeminal system. The syndrome consists of a classic triad of anaesthesia, paraesthesia, and a secondary persistent or recurrent facial ulceration. We describe a 60 year-old woman who developed this syndrome as a sequel to the gasserian ganglion block for trigeminal neuralgia. She had also developed melasma within 1 year. A remarkable benefit was achieved by proper patient education and topical antibiotics which led to the healing of all ulcerations within 4 weeks. In the case reported here, the diagnosis of the trigeminal trophic syndrome was made primarily as a result of the physician's experience with the syndrome previously.
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@#Objective To investigate the prostecdtive therapeutic efficacy of pulsed radiofrenquency and radiofrequency thermocoagulationof the Gasserian ganglion guided with spiral CT on trigeminal neuralgia. Methods 100 patients with idiopathic trigeminal neuralgiawere treated with pulsed radiofrenquency or radiofrequency thermocoagulation of gasserian ganglion. The numeric rating scales (NRS) ofpain were recorded before and 0.5 year, 1 year, and 2 years after treatment. Results There was no difference in NRS within 1 year, but the recurrencerate was high in the paitents accepted pulsed radiofrenquency 2 years later (P<0.01). Conclusion Pulsed radiofrenquency of thegasserian ganglion is safe and effective on trigeminal neuralgia, but poor in long-term outcome.
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Objective To observe the clinical effects and complications of primary trigeminal neuralgia treatment with radiofrequency thermocoagulation on gasserian ganglion. Methods Under the guidance of C-arm or DSA and with Hartel method, we percutaneously punctured the oval foramen to gasserian ganglion and performed radiofrequency times. Results Pain was completed eliminated in 53 of the 56 patients, which was regarded as degree Ⅰ of clinical cure with the curativeness rate being 96.4%; 1 case was of degree Ⅱ; 1 case was of degree Ⅲ; 1 case had no effect. The rate of satisfactory effectiveness was 96.4% and the total rate of efficacy was 98.2%. No severe complications were observed. Conclusion Radiofrequency thermocoagulation is a safe and effective method to treat primary trigeminal neuralgia with few severe complications.
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@#Objective To investigate the therapeutic efficacy and side-effect of pulsed radiofrequency and radiofrequency thermocoagulation for gasserian ganglion guided by spiral CT on trigeminal neuralgia. Methods 100 patients diagnosed as idiopathic trigeminal neuralgia were treated with pulsed radiofrequency or radiofrequency thermocoagulation for gasserian ganglion. They were assessed with numeric rating scales (NRS) before and 1 d，3 d，1 week， 1 month, 6 months and 12 month after treatment. The side effects were recorded. Results There was significant decrease in the scores of NRS after treatment compared with those before (P<0.01) in both groups. No serious side effects were observed. Conclusion Pulsed radiofrequency for gasserian ganglion for trigeminal neuralgia was effective and less side-effect.
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Since 1920, when Harvey Cushing first used radiofrequency in electrosurgery, the procedural technique has developed rapidly. Even though this procedure is minimally invasive and safer than other neurodestructive procedures, it is still not free of complications. A 72-year-old female patient had constant facial pain, despite several operations and radiotherapies for her maxillary cancer. The region innervated ophthalmic branch and maxillary branch of the trigeminal nerve was involved, with radiofrequency procedure of the gasserian ganglion for pain control also performed at the area. After the procedure, her blood pressure became elevated and she complained of a headache, and six hours later, she became irritable and distracted. Bacterial meningitis was diagnosed by a spinal tap, with third-generation cephalosporin administered as the treatment. The following day, her symptoms had improved and the pain was also reduced. She was discharged from hospital after 14 days, without any sequelae.
Subject(s)
Aged , Female , Humans , Blood Pressure , Electrosurgery , Facial Pain , Headache , Meningitis , Meningitis, Bacterial , Radiotherapy , Spinal Puncture , Trigeminal Ganglion , Trigeminal NerveABSTRACT
BACKGROUND: Inducible heat shock protein 70s (iHSP70) are expressed by stressful stimuli that result in protein denaturation, and are thought to assist in the maintenance of cellular integrity and viability. In addition, iHSP70 is known to be a sensitive marker of neuronal injury. To my best knowledge, no previous studies have been documented on iHSP70 induction by nociceptive impulse transmission through peripheral nerves not by direct neural damage. The purpose of this study was to examine the hypothesis that iHSP70 can be expressed in the nervous system, which is related to the dental nociceptive pathway, by tooth pulp inflammation. METHODS: The pulp of rat mandibular molars was exposed. Animals were sacrificed at 1, 4, and 7 days after pulpal exposure, and the pulps were evaluated histologically. Also, iHSP70 levels were examined in the Gasserian ganglion (GG) and the trigeminal sensory nucleus (TSN). RESULTS: At 4 days after pulpal exposure, iHSP70 was significantly more expressed in the ipsilateral GG than in the contralateral GG. In the histological study, inflammation was found in the entire pulp tissue at 4 days. There were no significant differences in iHSP70 levels between the ipsilateral TSN and the contralateral TSN. Also, there were no significant differences in iHSP70 expression of GG and TSN between both sides at 1 and 7 days after pulpal exposure. CONCLUSIONS: These results suggest that iHSP70 can be expressed in the GG at 4 days after pulpal exposure by nociceptive impulses due to pulpal inflammation.
Subject(s)
Animals , Rats , Heat-Shock Proteins , Hot Temperature , HSP70 Heat-Shock Proteins , Inflammation , Molar , Nervous System , Neurons , Peripheral Nerves , Protein Denaturation , Tooth , Trigeminal GanglionABSTRACT
BACKGROUND: Balloon volume is a very important factor in microcompression of the gasserian ganglion. Up until now, the range of figures for balloon inflation volumes came from foreign data. Experience has shown that the optimal range of balloon inflation volumes is somewhat different in Korean patients. Our aim was to determine mean, minimal, and maximal volumes among Korean patients. METHODS: In each case balloon volume was measured when protrusion through the porus trigemini occurred. From a total of thirty-three cases seen over a one year period, thirty will be considered here. The remaining three were excluded because of unsuccessful outcomes due to improper positioning of the balloon. This resulted in extreme balloon volumes in these three cases. RESULTS: The values determined from this group of patients were as follows: the mean was 0.55 ml, the maximum was 1.0 ml, and the minimum was 0.35 ml. The mean was 0.75 ml for males and 0.50 ml for females. However due to differences in age and height, this variation in the mean was not statistically significant. CONCLUSIONS: Although a comparison of the mean values is not possible because it has never been reported before now in foreign articles, the balloon volumes measured in Korean patients are generally smaller than those reported from Europe and North America.
Subject(s)
Female , Humans , Male , Europe , Inflation, Economic , North America , Trigeminal Ganglion , Trigeminal NeuralgiaABSTRACT
Persistent primitive trigeminal artery is relatively rare cerebrovascular anomaly, usually observed on angiography or at autopsy. We reported two cases of persistent primitive trigeminal artery. One is associated with spontaneous subarachnoid hemorrhage and the other intraventricular hemorrhage with scanty subarachnoid hemorrhage after minor head trauma. We reviewed the persistent primitive trigeminal artery and it's clinical significance. It's clinical significance seemed to be followed; 1) Formation of intracranial aneurysm due to increased arterial blood flow. 2) pathway for microemboli from carotid system to basilar system. 3) probable cause hemodynamic cerebral ischemia. 4) unexpected finding during surgical procedure.