经卵圆孔联合圆孔选择性射频热凝治疗Ⅱ+Ⅲ支原发性三叉神经痛的疗效观察

Selective radiofrequency thermocoagulation via the foramen ovale and foramen rotundum for the treatment of Ⅱ+Ⅲ branches idiopathic trigeminal neuralgia: observation of its curative effect

目的观察经卵圆孔联合圆孔选择性射频热凝治疗Ⅱ+Ⅲ支原发性三叉神经痛(ITN)的临床疗效。方法回顾性分析60例行卵圆孔联合圆孔选择性射频热凝治疗的ITNⅡ+Ⅲ支患者,采用巴罗神经学研究所疼痛评价表(Barrow Neurological Institute,BNI)评估疗效,观察术后第1天有效率及并发症,随访2年,采用Kaplan-Meier生存曲线表示术后2年疗效。结果术后第1天总有效率为96.7%,术后2年总复发率为41.8%;Ⅱ、Ⅲ支分组进行疗效曲线比较Ⅱ支疗效优于Ⅲ支,差异有统计学意义(P<0.05);不良反应有颜面肿胀16例(28.07%),Ⅱ支麻木48例(84.21%)、Ⅲ支麻木34例(59.64%)。结论卵圆孔联合圆孔选择性射频热凝术是一种高安全性、高选择性、高精确性的治疗Ⅱ+Ⅲ支ITN的手术方式。

Objective To evaluate the clinical curative effect of selective radiofrequency thermocoagulation via the foramen ovale and foramen rotundum in treatingⅡ+Ⅲbranches idiopathic trigeminal neuralgia(ITN).Methods The clinical data of a total of 60 patients withⅡ+Ⅲbranches ITN,who were treated with selective radiofrequency thermocoagulation via the foramen ovale and foramen rotundum,were retrospectively analyzed.Barrow Neurological Institute(BNI)pain assessment scale was used to evaluate the curative effect.The effective rate and complications were recorded on the first day after treatment.The patients were followed up for 2 years.Kaplan-Meier survival curve was used to evaluate the 2-year postoperative effective rate.Results The total effective rate on the first day after treatment was 96.67%,and the 2-year postoperative total recurrence rate was 41.81%.There were statistically significant differences in curative effect and survival curve between theⅡbranch group andⅢbranch group(P<0.05).Complications included facial swelling(n=16,28.07%),numbness of branchⅡarea(n=48,84.21%)and numbness of branchⅢarea(n=34,59.64%).Conclusion For the treatment ofⅡ+Ⅲbranches ITN,selective radiofrequency thermocoagulation via the foramen ovale and foramen rotundum is an effective method,which is highly-safe,highly-selective and highly-accurate.(J Intervent Radiol,2020,29:686-689)