Retrogasserian thermolysis in trigeminal neuralgia
Makaleler > Tam Makale · 2009
Yazarlar: Mehmet ZİLELİ
Ukrainian Neurosurgical Journal, Uluslararası, 2009
Özet
Goal: This paper aims to analyse long term results of retrogasserian RF lesions for trigeminal neuralgia. Materials and Methods: Between 1992 and 1998 a total 213 patients presented with trigeminal neuralgia were treated. Mean age was 59±13 (min 24, max 90), Male/Female ratio was 89/121. The pain was on right in 134 cases and on left in 79 cases. The distribution of the pain in divisions was: division I: 4, division I & II: 22, division II: 52, division II & III: 68, division III: 36, all divisions: 31. Secondary trigeminal neuralgia presented in 21 cases (9,9%): The etiology of trigeminal neuralgia was attributed to multiple sclerosis in 8 (3,8%), cerebellopontin angle tumor in 5 (2,3%), vascular lesions in 4 (1,9%), blood disorders in 2 (0,9%), basilary invagination and Chiari syndrome in 1 (0,5%), arachnoid cyst in 1 (0,5%) Trigeminal neuralgia was accompanied with hemifascial spasm in 4 (1,9%), with hemifascial spasm & tinnitus in 1 (0,5%). Bilateral trigeminal neuralgia presented in 7 patients (3,3%). The technique we used was performed under fluoroscopic control and division specific lesions by radiofrequency thermocoagulation at 75 degree centigrade for 60 seconds. During RF lesions IV diprivan anesthesia was applied. Results and Discussion: We examined 116 patients with more than 5 year follow ups and total application of 142 RF rhizotomies. Initial success rate was 98%. Recurrence rate was 15%. Recurrence interval was on average 18 months (1-36) Number of RF applications in this group was one time only in 93 cases, 2 times in 20 cases, 3 times in 3 cases. Complications were transient 6th nerve palsy in 2, carotid artery puncture in 1, anesthesia dolorosa in 1. There were no death and no significant morbidity. Conclusions: Retrogasserian RF thermolysis for trigeminal neuralgia is an easy and and non-ambulatory technique which allows division specific pain relief with very high success rate and small number of reversible complications. Posterior Surgery for Kyphosis