CT-guided percutaneous puncture and chemical mutilation of gasserian gangtion in the treatment of trigeminal neuralgia:comparison of the effects of ethyl alcohol and adriamycfal / 中华麻醉学杂志

ABSTRACT

Objective Percutaneous puncture of gasserian ganglion was guided by CT scan to improve the accuracy and reduce complications and to compare the efficacy of chemical mutilation with ethyl alcohol and adriamycin.Methods Ninety-two patients with primary trigeminal neuralgia (39 males, 53 females) aged 37-84 yrs were divided into two groups A ethyl alcohol group ( n = 47) and B adriamycin group ( n = 45) . Secondary trigeminal neuralgia was excluded by preoperative CT scan. Percutaneous puncture of oval foramen was guided by CT and correct location of needle tip was confirmed by injection of contrast medium. 100% ethyl alcohol 0.5ml (group A) or 2% adriamycin 0.5ml was injected.Results The patients were followed up for 12 months after treatment. Neuralgia disappeared in 31 out of 47 patients in group A (alcohol group) and in 36 out of 45 patients in group B (adriomycin group) . Treatment failed in 13 patients in group A and 6 patients in group B, and was partly effective in the other patients. There were no severe side effects or complications. Conclusion Percutaneous puncture of gasserian ganglion guided by CT is effective and reduces complications. Adriamycin is more effective than ethyl alcohol for chemical mutilation.