The Long-Term Effective Rate of Different Branches of Idiopathic Trigeminal Neuralgia After Single Radiofrequency Thermocoagulation

Tang, Yue; Wu, Baishan; Yang, Liqiang; Yue, Jianning; He, Lin; Li, Na; Ni, Jiaxiang

doi:10.1097/md.0000000000001994

Cited by 38 publications

(46 citation statements)

References 22 publications

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“…Among these cases, 15 (24.2%) patients had moderate facial numbness (BNI score III) and 2 (3.2%) had severe facial numbness (BNI score IV) that affected their quality of life. The severity of facial numbness at 75°C in our study is less than that reported by Tang et al, [6] who adopted RFT at 75°C to 85°C, and the incidence of facial numbness at 75°C is also lower than that in previous reports, including one report of RFT at a higher temperature in which 98% of patients had facial numbness [37] and a report by Lai et al [5] in which 87.8% of patients had facial numbness after RFT at 75°C for treatment of recurrent TN. There were 8 (12.9%) patients who had mild facial numbness after RFT at 68°C in the current study, and this rate is also lower than that previously reported for RFT at a higher temperature.…”

Section: Discussioncontrasting

confidence: 88%

“…However, these studies have focused mainly on overall treatment results of RFT, whereas the effects of different temperatures have not been investigated. This study was designed to compare efficacy, safety, and patient satisfaction after RFT at 75°C (a clinically common temperature) [5,6,27] and 68°C (a lower temperature) in cases of bilateral ITN, with the final purpose of providing definite guidance for clinicians. In order to exclude the effects of individual subjectivity on pain evaluation, the study was performed in patients with bilateral ITN and RFT was performed bilaterally at different temperatures on each side.…”

Section: Discussionmentioning

confidence: 99%

“…There were 8 (12.9%) patients who had mild facial numbness after RFT at 68°C in the current study, and this rate is also lower than that previously reported for RFT at a higher temperature. [6,27] …”

Section: Discussionmentioning

confidence: 99%

“…Radiofrequency thermocoagulation (RFT) is an efficient, minimally invasive treatment with few complications and has a wide variety of clinical applications, and it is one of the main therapies for TN. [4–6] Response rates of 77.5% to 97.6% are reported after RFT, [4,7,8] with short-term efficacy of up to 100%, [9] and the operation time under C-arm or computed tomography (CT) guidance is 15 to 55 min. [10–12] Recently, RFT has been modified using the stereotaxic apparatus to reduce operation-related subsidiary injury.…”

Section: Introductionmentioning

confidence: 99%

“…[10–12] Recently, RFT has been modified using the stereotaxic apparatus to reduce operation-related subsidiary injury. [13] Nonetheless, in one study, 100% of patients developed facial numbness after RFT, [14] and Tang et al [6] have reported that 96% of patients with TN of mandibular division (V3) experienced masticatory atonia. Cases of blindness have also been reported.…”

Section: Introductionmentioning

confidence: 99%

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Treatment of bilateral idiopathic trigeminal neuralgia by radiofrequency thermocoagulation at different temperatures

et al. 2016

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Radiofrequency thermocoagulation (RFT) is an effective treatment for trigeminal neuralgia, but consensus regarding an optimal treatment temperature is lacking. While treatment temperatures ranging from 60°C to 95°C have been reported, RFT at too high a temperature is often followed by serious complications, and comparative evaluations of RFT at different temperatures in a single study are rare.This current prospective cohort study was to compare immediate and long-term outcomes of RFT at varying temperatures in patients with bilateral idiopathic trigeminal neuralgia (ITN) of maxillary division of trigeminal nerve (V2), mandibular division of trigeminal nerve (V3), and V2+V3, including pain relief, complications, recurrence rate, and patient satisfaction. From May 2011 to April 2016, 62 consecutive patients with bilateral ITN of V2, V3, and V2+V3 were enrolled in the study. These patients underwent bilateral RFT at 68°C and 75°C, respectively, using the same RF parameters. Side-to-side results, including pain relief, complications, and patient satisfaction, were compared during a 5-year follow-up period.Overall pain relief was satisfactory after RFT. The rate of pain relief after treatment at 75°C was slightly higher than at 68°C (P > 0.05). The pain-free rate was 95.1% at 75°C and 93.5% at 68°C at 1 year, 84.3% and 78.1% at 3 years, and 80.7% and 74.4% at 5 years. There were 10 and 13 cases of recurrence, respectively, and 6 cases of bilateral recurrence. The incidence and severity of complications were greater at 75°C (P < 0.05) than at 68°C, and therefore the patient satisfaction at the higher temperature was lower (P < 0.05).Patients with bilateral ITN who underwent RFT at different temperatures had consistent pain relief after RFT at both 75°C and 68°C, but there were fewer and less severe complications at 68°C, which was accompanied by greater patient satisfaction. This suggests that RFT at lower temperatures may be preferable, and that a temperature of 68°C can be recommended.

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Section: Discussioncontrasting

confidence: 88%