Comparison of percutaneous balloon compression and radiofrequency-thermocoagulation in the management of trigeminal neuralgia

Herta, Johannes; Loidl, Theresa Bettina; Schmied, Tobias; Tomschik, Matthias; Khalaveh, Farjad; Wang, Wei-Te; Dorfer, Christian

doi:10.21203/rs.3.rs-2545167/v1

Cited by 1 publication

(1 citation statement)

References 37 publications

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“…RF treatment has shown a commendably low complication rate, comparable to other percutaneous techniques. 6,17,[20][21][22][23][24] Despite this, since its introduction in 1974 by Sweet and Wepsic, with its extensive application in TN, and improvement of RF generators and parameters used, an immediate pain relief was reported to be as high as 85 to 97% by more recent studies. 11,[25][26][27] MVD is not a minor procedure and its application in elderly patients has been always a concern, but recently published series in older age groups indicate that the decision to recommend MVD should be based upon the patient's fitness rather than his age.…”

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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