We evaluated the immediate and long-term clinical efficacy of computed tomography （CT）-guided radiofrequency thermocoagulation for primary trigeminal neuralgia （RTPTN） in 852 patients including 502 patients aged -...We evaluated the immediate and long-term clinical efficacy of computed tomography （CT）-guided radiofrequency thermocoagulation for primary trigeminal neuralgia （RTPTN） in 852 patients including 502 patients aged -〉 60 years and 350 patients aged 〈 60 years. After discharge, the incidence of complications was 1.0% and 0.9% in patients aged 〉 60 years and patients aged 〈 60 years, respectively. Over 3-year follow-up after CT-guided RTPTN, 96.8% of the patients aged 〉 60 years and 98.6% of the patients aged 〈 60 years were completely pain-free, and there was no significant difference between these two age brackets. In addition, there were no significant differences in quality of life scores and numbness scores between these two age brackets. These findings suggest that CT-guided RTPTN is a safe and effective method and is recommended for older and poor-risk patients.展开更多
Objective： To quantitatively identify and grade trigeminal sensory functions after 3 major surgical procedures of trigeminal neuralgia using a newly developed quantitative sensory testing technique, current perceptio...Objective： To quantitatively identify and grade trigeminal sensory functions after 3 major surgical procedures of trigeminal neuralgia using a newly developed quantitative sensory testing technique, current perception threshold measurement （CPTM）. Methods： In the current study, there were 48 trigeminal neuralgia patients without history of prior surgical treatment. These patients received one of the following 3 surgical procedures, microvascular decompression （MVD）, peripheral nerve block with alcohol （PNB）, or percutaneous radiofrequency thermocoagulation （PRFT）. The quantitative sensory testing measurement, CPTM, and conventional qualitative sensory testing measurements were performed preoperatively and postoperatively to evaluate and grade the trigeminal sensory functions All 3 major cutaneous sensory fiber types, large myelinated fibers （A beta）, small myelinated fibers （A delta） and unmyelinated fibers（C） were allowed to quantitatively evaluate and grade by CPTM. The results of the measurements were statistically analyzed using a one-way analysis of variance （single factor）. Each subject was his/her own control for comparison of the preoperative to postoperative state on the asymptomatic and symptomatic sides. Subjects were tested 48 h preoperatively and 4 weeks postoperatively. Results： PNB with alcohol and PRFT caused significant sensory dysfunction postoperatively in every fiber type, indicating damage to all fibers. On the contrary, the sensory function in all 3 fiber types was unchanged after MVD management. Conclusion： Among the 3 major surgical procedures tested, only MVD preserves sensory function in trigeminal system. CPTM is of quantitative nature on the evaluation of sensory functions of nerve fibers展开更多
基金the National Natural Science Foundation of China,81041023, 30972851
文摘We evaluated the immediate and long-term clinical efficacy of computed tomography （CT）-guided radiofrequency thermocoagulation for primary trigeminal neuralgia （RTPTN） in 852 patients including 502 patients aged -〉 60 years and 350 patients aged 〈 60 years. After discharge, the incidence of complications was 1.0% and 0.9% in patients aged 〉 60 years and patients aged 〈 60 years, respectively. Over 3-year follow-up after CT-guided RTPTN, 96.8% of the patients aged 〉 60 years and 98.6% of the patients aged 〈 60 years were completely pain-free, and there was no significant difference between these two age brackets. In addition, there were no significant differences in quality of life scores and numbness scores between these two age brackets. These findings suggest that CT-guided RTPTN is a safe and effective method and is recommended for older and poor-risk patients.
文摘Objective： To quantitatively identify and grade trigeminal sensory functions after 3 major surgical procedures of trigeminal neuralgia using a newly developed quantitative sensory testing technique, current perception threshold measurement （CPTM）. Methods： In the current study, there were 48 trigeminal neuralgia patients without history of prior surgical treatment. These patients received one of the following 3 surgical procedures, microvascular decompression （MVD）, peripheral nerve block with alcohol （PNB）, or percutaneous radiofrequency thermocoagulation （PRFT）. The quantitative sensory testing measurement, CPTM, and conventional qualitative sensory testing measurements were performed preoperatively and postoperatively to evaluate and grade the trigeminal sensory functions All 3 major cutaneous sensory fiber types, large myelinated fibers （A beta）, small myelinated fibers （A delta） and unmyelinated fibers（C） were allowed to quantitatively evaluate and grade by CPTM. The results of the measurements were statistically analyzed using a one-way analysis of variance （single factor）. Each subject was his/her own control for comparison of the preoperative to postoperative state on the asymptomatic and symptomatic sides. Subjects were tested 48 h preoperatively and 4 weeks postoperatively. Results： PNB with alcohol and PRFT caused significant sensory dysfunction postoperatively in every fiber type, indicating damage to all fibers. On the contrary, the sensory function in all 3 fiber types was unchanged after MVD management. Conclusion： Among the 3 major surgical procedures tested, only MVD preserves sensory function in trigeminal system. CPTM is of quantitative nature on the evaluation of sensory functions of nerve fibers
