Reduced effect of percutaneous retrogasserian glycerol rhizolysis in trigeminal neuralgia affecting the third branch.

Abstract

INTRODUCTION:

The objective of this study was to determine the long-term efficacy of percutaneous glycerol rhizolysis of the trigeminal ganglion for treating patients with trigeminal neuralgia and search for predictors associated with (long-term) benefit to improve patient selection.

METHODS:

A retrospective study in 60 consecutive patients treated with percutaneous glycerol rhizolysis of the trigeminal ganglion for trigeminal neuralgia. Charts were reviewed in combination with follow-up by questionnaire (n = 55, 92% response).

RESULTS:

Initial pain relief was achieved in 92% of the patients. Pain-free survival was 59% of the patients at 12 months and 53% at 24 months. Most common side effects were hypesthesia (15%), dry eye (5%), and meningitis (2%). In patients without involvement of the third branch of the trigeminal nerve, the initial effect was 79%, of which 90% achieved more than 2 years pain-free survival, compared with 97% initial effect and less than 40% pain-free survival of more than 2 years when the third trigeminal branch was involved.

DISCUSSION:

The present study demonstrates that involvement of the third branch is a negative predictor for long-term outcome in percutaneous glycerol rhizolysis of the trigeminal ganglion in patients with classical trigeminal neuralgia. However, in the absence of third-branch involvement, glycerol rhizolysis yields excellent long-term results when initial positive effect is obtained.

• Authors: Mark V Koning, Nick J Koning, Henk M Koning
• Journal: Pain practice : the official journal of World Institute of Pain (Pain Pract) Vol. 15 Issue 3 Pg. 217-22 (Mar 2015) ISSN: 1533-2500 [Electronic] United States
• PMID: 25914913 (Publication Type: Journal Article)

Chemical References

• Solvents
• Glycerol

Topics

• Age Factors
• Aged
• Aged, 80 and over
• Female
• Glycerol (therapeutic use)
• Humans
• Male
• Mandibular Nerve
• Middle Aged
• Pain Management
• Patient Selection
• Retrospective Studies
• Rhizotomy (methods)
• Solvents (therapeutic use)
• Surveys and Questionnaires
• Treatment Outcome
• Trigeminal Ganglion
• Trigeminal Neuralgia (therapy)