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Idopathic tigeminal neuralgia: Radiophrequency rhizotomy of ganglion Gasseri

Author(s): Slavik Eugen | Ivanović S. | Spaić M. | Đurović B.

Journal: Acta Chirurgica Iugoslavica
ISSN 0354-950X

Volume: 51;
Issue: 4;
Start page: 31;
Date: 2004;
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Keywords: trigeminal neuralgia | radiofrequencyrhizotomy | thermocoagulation | Gasserianganglion

Idiopathic trigeminal neuralgia (ITN), ( tic douloureux), may be defined as a chronic painfull disorder of the sensory divisions of the trigeminal nerve, with unexplained cause and pathogenesis. The clinical features are characterized by recurrent paroxysmal lancinating pain confined to distribution of one or more branches of the nerve. Radio frequency rhizotomy (RFR) of ganglion Gasseri is a method of choice in treatment of ITN. We present the series of 1600 patients suffering from ITN who underwent RFR between 1984 and 2001. Ages ranged from 29 to 88 years, with a mean age of 62 years. Total pain relief immediately after a single radio frequency lesion was achieved in 1469 (92%) of patients. After one year a recurrence of pain was present in 145 (10%). Age, sex and duration of illness were unrelated to outcome. Patients previously treated by open surgery appeared to receive less benefit from subsequent RFR. Clinical outcome correlated with the degree of sensory deficit created by RFR. Patients acquiring dense deficit demonstrated a reduced risk of recurrence: 203/1129 (18%) of patients with dense sensory loss and 75/258 (29%) of those with a partial deficit developed a recurrence by three years, whereas almost all patients (78/82) without initial sensory loss suffered a recurrence by three years. Serious complications resulting from RFR were infrequent and the most common was the permanent dysesthesia in 9 (0,6%) of patients. Our results suggest that the RFR is an well bearable and effective long term surgical treatment for ITN, especially for older and poor-risk patients.
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