Effects of Supraorbital Foramen Variations on the Treatment Efficacy of Radiofrequency Therapy for V1 Trigeminal Neuralgia: A Retrospective Study

Abstract

Background. Primary V1 trigeminal neuralgia is a common refractory neuralgia in clinical practice, lacking effective treatments. Radiofrequency therapy has certain treatment efficacy, but its long-term efficacy remained poor and the disease might relapse. Objective. To compare the effects of different types of supraorbital foramen variations on the treatment efficacy of radiofrequency therapy for V1 trigeminal neuralgia. Methods. Data of 54 patients with V1 trigeminal neuralgia who underwent treatment in the First Hospital of Jiaxing, Zhejiang, were retrospectively analyzed. All these patients received CT-guided radiofrequency thermocoagulation of supraorbital nerve. According to the CT images, the supraorbital foramen of the patients was categorized as holes (hole group) or notches (notch group). The patient characteristics, including Numerical Rating Scale (NRS) score and effective treatment rates before and 1 d, 0.5 y, 1 y, and 2 y after operation, and numbness degree at day 1 and 2 y after the operation were compared. The short- and long-term complications during postoperative follow-up period were also recorded. Results. Among the 54 patients, 25 patients were grouped into the hole group and 29 into the notch group. The NRS scores before and at 1 d, 0.5 y, 1 y, and 2 y after operation showed no significant differences between the two groups. However, the NRS scores at the remaining time points after operation were significantly decreased when compared with scores before operation (P<0.05). The numbness and numbness degree after operation showed no significant differences between the two groups. The numbness degree at 2 y after operation was significantly lower than 1 d after operation (P<0.05). The effective rate at 1 d, 0.5 y, and 1 y after operation showed no significant differences between the hole and notch groups. However, the effective rate at 2 y after operation was significantly lower in the notch group than hole group (P<0.05). No severe short- or long-term complications were found in either group. Conclusion. The short- and long-term effective rates of radiofrequency therapy during V1 trigeminal neuralgia treatment are relatively high in patients with different types of supraorbital foramen variations. However, the effective rate is even higher in patients with hole-type supraorbital foramen. No other severe complications, except numbness, were found, and the acceptability rate remained high in patients.

Efficacy and Safety of Radiofrequency Thermocoagulation with Different Puncture Methods for Treatment of V1 Trigeminal Neuralgia: A Prospective Study

“…Liu et al (19) have also reported that RFT is an effective and safe therapy for patients with persistent or recurrent trigeminal neuralgia. RFT temperatures ranging from 60 to 95°C are usually used for the treatment of trigeminal neuralgia (20)(21)(22). These studies suggest that RFT with higher temperature is safe and effective in the treatment of trigeminal neuralgia and could reduce the recurrence rate of trigeminal neuralgia.…”

“…Therefore, in this study, the 95°C temperature was selected for the RFT of the V1TN with the aim of achieving a complete pain block and improved therapeutic outcomes. Xie et al (22) reported that RFT through the supraorbital foramen was a safer method than through the Gasserian ganglion since it could reduce corneal injury and other complications. Therefore, in this study, we adopted the RFT method through the supraorbital foramen for the treatment of V1TN.…”

Chinese expert consensus on minimally invasive interventional treatment of trigeminal neuralgia

“…The higher the temperature is, the longer the time, the greater the extent of nerve destruction, and the lower the recurrence rate. However, this treatment can induce a higher probability of adverse complications, such as keratitis or ulcer perforation, excessive numbness of the corresponding innervation area of the trigeminal nerve, and masseter muscle weakness after the operation ( Xie et al, 2020 ). Therefore, during the treatment process, the patient’s treatment benefits and risks should be weighed, and as low a temperature as possible should be selected while still being effective.…”

“…Therefore, during the treatment process, the patient’s treatment benefits and risks should be weighed, and as low a temperature as possible should be selected while still being effective. In addition, pulsed radiofrequency therapy is available ( Elawamy et al, 2017 ; Telischak et al, 2018 ; Abdel-Rahman et al, 2020 ; Xie et al, 2020 ).…”

Domain Heterogeneity in Radiofrequency Therapies for Pain Relief: A Computational Study with Coupled Models

“…However, there are significant contradictions and inconsistencies in the reported clinical results on the efficacy of RF procedures. Most of the clinical studies available in the literature are retrospective studies or case studies limited to reporting high-quality randomized controlled trials [47][48][49][50][51][52][53][54][55]. Furthermore, inappropriate selection criteria and treatment parameters could result in poor treatment outcomes, whereas anatomical variations, which are still not well-established, could limit the accurate interpretation of the obtained results.…”