Hostname: page-component-848d4c4894-nr4z6 Total loading time: 0 Render date: 2024-06-10T06:55:42.890Z Has data issue: false hasContentIssue false
  • English
  • Français

Trigeminal Neuralgia: A Comparison of the Results of Percutaneous Rhizotomy and Microvascular Decompression

Published online by Cambridge University Press:  18 September 2015

G.G. Ferguson ,
D.C. Brett ,
S.J. Peerless ,
H.W.K. Barr  and
J.P. Girvin
G.G. Ferguson*
Affiliation:
Division of Neurosurgery, Department of Clinical Neurological Sciences, The University of Western Ontario, London, Canada
D.C. Brett
Affiliation:
Division of Neurosurgery, Department of Clinical Neurological Sciences, The University of Western Ontario, London, Canada
S.J. Peerless
Affiliation:
Division of Neurosurgery, Department of Clinical Neurological Sciences, The University of Western Ontario, London, Canada
H.W.K. Barr
Affiliation:
Division of Neurosurgery, Department of Clinical Neurological Sciences, The University of Western Ontario, London, Canada
J.P. Girvin
Affiliation:
Division of Neurosurgery, Department of Clinical Neurological Sciences, The University of Western Ontario, London, Canada
*
F.R.C.S. (C), University Hospital, P.O. Box 5339, Terminal “A”, London, Ontario, Canada, N6A 5A5
Rights & Permissions [Opens in a new window]

Summary:

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Seventy-five patients were treated between March 1976 and June 1980 for classical idiopathic tic douloureux. Fifty-five patients underwent percutaneous trigeminal rhizotomy (PTR) and twenty-four had posterior fossa microvascular decompression (M VD) of the trigeminal nerve. Four patients had both procedures. In the PTR group. 4% were immediate failures, 42% had a delayed recurrence of pain, while 54% remained totally pain free with an average follow-up of 30 months. In the MVD group, 12% were immediate failures, 17% had a delayed recurrence of pain, and 71% have remained free of pain with an average follow-up of 28 months. Neither procedure can be regarded as ideal surgical treatment for patients with pain refractory to medical treatment. Percutaneous rhizotomy has an established place because of its safety, particularly in elderly patients. A high rate of recurrent pain is to be expected. Microvascular decompression has appeal in younger patients because of its non-destructive nature but the long term efficacy of the procedure is not known.

Type
Research Article
Information
Canadian Journal of Neurological Sciences , Volume 8 , Issue 3 , August 1981 , pp. 207 - 214
Copyright
Copyright © Canadian Neurological Sciences Federation 1981

References

REFERENCES

Apfelbaum, R.I. (1977). A comparison of percutaneous radio-frequency trigeminal neurolysis and microvascular decompression of the trigeminal nerve for the treatment of tic douloureux. Neurosurgery 1: 16–21.CrossRefGoogle Scholar
Brett, D.C.Ferguson, G.G.Ebers, G.C. and Paty, D.W. (1981). Percutaneous trigeminal rhizotomy in the treatment of trigeminal neuralgia secondary to multiple sclerosis. (In press)CrossRefGoogle Scholar
Dandy, W.E., (1934). Concerning the cause of trigeminal neuralgia. Am. J. Surg. 24: 447–455.CrossRefGoogle Scholar
Haines, S.J.Jannetta, P.J., and Zorub, D.S., (1980). Microvascular relations of the trigeminal nerve: an anatomical study with clinical correlation. J. Neurosurg. 52: 381–386.Google Scholar
Hardy, D.G. and Rhoton, A.L. Jr. (1978). Microsurgical relationships of the superior cerebellar artery and the trigeminal nerve. J. Neurosurg. 49: 669–678.CrossRefGoogle ScholarPubMed
Jannetta, P.J., (1976). Microsurgical approach to the trigeminal nerve for tic douloureux. Prog. Neurol. Surg. 7: 180–200.CrossRefGoogle Scholar
Jannetta, P.J. (1977). Treatment of trigeminal neuralgia by suboccipital and transtentorial cranial operations. Clin. Neurosurg. 24: 538–549.CrossRefGoogle ScholarPubMed
Jannetta, P.J., (1979). Microsurgery of cranial nerve cross-compression. Clin. Neurosurg. 26: 607–615.Google ScholarPubMed
Jannetta, P.J. and Zorub, D.S., (1979). Microvascular decompression for trigeminal neuralgia. In, Surgery of the Posterior Fossa. Ed. Buckheit, W.A. and Truex, R.C., Raven Press, New York, pp 143–154.Google Scholar
Kelly, D.L., (1977). Posterior fossa neurovascular decompression for tic douloureux and hemifacial spasm. North Carolina Med. J. 38: 534–536.Google ScholarPubMed
Kirschner, M.,(1942). Die Behandlungder Trigeminusneuralgie (nach Erfahrungen an 1113 Kranken). Munchen Med. Wschr. 89: 235–239.Google Scholar
Menzel, J., Piotrowski, W., and Penzholz, H. (1975). Long-term results of Gasserian ganglion electrocoagulation. J. Neurosurg. 42: 140–143.CrossRefGoogle ScholarPubMed
Morley, J.P., (1977). The place of peripheral and subtemporal ablative operations in the treatment of trigeminal neuralgia (tic douloureux). Clin. Neurosurg. 24: 550–556.CrossRefGoogle ScholarPubMed
Nugent, G.R. and Berry, B., (1974). Trigeminal neuralgia treated by differential percutaneous radiofrequency coagulation of the Gasserian ganglion. J. Neurosurg. 40: 517–523.CrossRefGoogle ScholarPubMed
Onofrio, B.M., (1975). Radiofrequency percutaneous Gasserian ganglion lesions: results in 140 patients with trigeminal pain. J. Neurosurg. 42: 132–139.CrossRefGoogle ScholarPubMed
Petty, P.G. and Southby, R. (1977). Vascular compression of lower cranial nerves: observations using microsurgery, with particular reference to trigeminal neuralgia. Aust. N.Z.J. Surg. 47: 314–320.CrossRefGoogle ScholarPubMed
Rhoton, A.L. Jr. (1978). Microsurgical neurovascular decompression for trigeminal neuralgia and hemifacial spasm. J. Florida Med. Ass. 65: 425–428.Google ScholarPubMed
Siegfried, J. (1977). 500 percutaneous thermocoagulations of the Gasserian ganglion for trigeminal pain. Surg. Neurol. 8: 126–131.Google ScholarPubMed
Sweet, W.H. and Wepsic, J.G. (1974). Controlled thermocoagulation of trigeminal ganglion and rootlets for differential destruction of pain fibres. Part I: trigeminal neuralgia. J. Neurosurg. 40: 143–156.CrossRefGoogle Scholar
Sweet, W.H. (1976). Treatment of facial pain by percutaneous differentia] thermal trigeminal rhizotomy. Prog. Neurol. Surg. 7: 153–179.CrossRefGoogle Scholar
Tew, J.M. Jr. and Keller, J.T. (1977). The treatment of trigeminal neuralgia by percutaneous radiofrequency technique. Clin. Neurosurg. 24: 557–578.CrossRefGoogle ScholarPubMed
Turnbull, I.M. (1974). Percutaneous rhizotomy for trigeminal neuralgia. Surg. Neurol. 2: 385–389.Google ScholarPubMed