Trigeminal Neuralgia: Role and Neurosurgical Indications of Peripheral Alcohol Injections, Controlled Radiofrequency Thermocoagulation, Gasserian Ganglion Compression with Balloon and Microvascular Decompression in Posterior Cranial Fossa. Experience in 437 PatientsMario Francesco Fraioli*, Mario Lecce, Damiano Lisciani and Bernardo Fraioli
University of Rome “Tor Vergata”, Department of Neurosciences, Neurosurgery
- Corresponding Author:
- Dr. Mario Francesco Fraioli
University of Rome “Tor Vergata”
Department of Neurosciences, Neurosurgery
Via Oxford 81, 00133
E-mail: [email protected]
Received date: December 27, 2010; Accepted date: February 12, 2011; Published date: February 16, 2011
Citation: Fraioli MF, Lecce M, Lisciani D, Fraioli B (2011) Trigeminal Neuralgia: Role and Neurosurgical Indications of Peripheral Alcohol Injections, Controlled Radiofrequency Thermocoagulation, Gasserian Ganglion Compression with Balloon and Microvascular Decompression in Posterior Cranial Fossa. Experience in 437 Patients. J Neurol Neurophysiol 2:109. doi:10.4172/2155-9562.1000109
Copyright: © 2011 Fraioli MF, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Introduction: Trigeminal neuralgia is a common cause of facial pain. Many therapies are accomplishable; purpose of the study is to evaluate the role and the indications, in our experience, of peripheral alcohol injections, controlled radiofrequency thermocoagulation, gasserian ganglion compression with balloon and microvascular decompression in posterior cranial fossa.
Methods: A series of 437 patients treated with various surgical methods for idiopathic trigeminal neuralgia refractory to medical therapy is presented. The treatments were performed according to the interested trigeminal division, the gravity of the neuralgia, the age and the general conditions of the patients. Moreover, the role of radiosurgery is underlined.
Results: Peripheral alcohol injections resulted very effective for temporary control of dolorific attacks. Thermocoagulation resulted a very effective and stable method for isolated III division trigeminal neuralgia; balloon compression was very effective for pain control but entire hemifacial anesthesia was necessary to obtain a good outcome; microvascular decompression resulted affective but was reserved for young healthy patients (trigeminal neuralgia is predominant in advanced age).
Conclusions: In our opinion, each treatment should be indicated according to neuralgia (interested trigeminal division, gravity) and patient (age, general conditions) characteristics, to perform the best treatment for each patient.