Precutaneous radiofrequency neurolysis for trigeminal neuralgia

ABSTRACT

In this retrospective study efficiency of selective percutaneous radiofrequency neurolysis in the gasserian ganglion was evaluated in 200 patients with a mean follow-up of seven years by the senior author and co-workers at the Department of Neurosurgery at St. George's Hospital Beirut. Mean age of patients was 60 years with a predominant number of patients having essential neuralgia [184 patients]. Excellent relief was obtained in 92 patients with another 36 patients achieving pain relief after a second intervention. Sixty-nine patients had recurrence not amenable to repeat intervention. And another 3 patients had bad penetration of foramen ovale. Thirty-two patients required reintervention with glycerol and fibrin glue. Complications included sensory loss of cornea in 6 cases, anaesthesia dolorosa in 8 cases, coagulation of motor root of the fifth nerve in 2 cases, intense pain of the ear [paralysis of tensor tympani] in 4 cases and damage to oculomotor nerve in one case. The authors propose that radiofrequency rhizotomy may be a safe and effective procedure in the neurosurgical armamentarium for the treatment of patients having trigeminal neuralgia