Hong Tao, Ding Yuanyuan, Yao Peng
Department of Pain Management, Shengjing Hospital of China Medical School, No. 36, Sanhao Street, Heping District, Shenyang 110004, China.
Biochem Res Int. 2020 Mar 4;2020:3854284. doi: 10.1155/2020/3854284. eCollection 2020.
Trigeminal neuralgia (TN) is a common neuropathic pain that seriously affects the daily life of patients. Many invasive treatments are currently available for patients who respond poorly to oral carbamazepine or oxcarbazepine. Among them, radiofrequency (RF) treatment is a viable option with reliable initial and long-term clinical efficacy. The long-term analgesic effects of radiofrequency thermocoagulation (RFT) at high temperatures (≥80°C) are not superior to those at relatively low temperatures (60-75°C). In contrast, the higher the temperature, the greater the risk of complications, especially facial numbness, masticatory muscles weakness, and corneal hypoesthesia. Some patients even experience irreversible lethal complications. Therefore, we recommend low-temperature RFT (60-75°C) for treatment of TN. The therapeutic effects of pulsed radiofrequency (PRF) are controversial, whereas PRF (≤75°C) combined with RFT can improve long-term effects and decrease the incidence of complications. However, large-scale clinical trials are needed to verify the efficacy of the combination of PRF and RFT.
三叉神经痛（TN）是一种常见的神经性疼痛，严重影响患者的日常生活。对于口服卡马西平或奥卡西平疗效不佳的患者，目前有多种侵入性治疗方法可供选择。其中，射频（RF）治疗是一种可行的选择，具有可靠的初始和长期临床疗效。高温（≥80°C）射频热凝术（RFT）的长期镇痛效果并不优于相对低温（60-75°C）时的效果。相反，温度越高，并发症风险越大，尤其是面部麻木、咀嚼肌无力和角膜感觉减退。一些患者甚至会出现不可逆的致命并发症。因此，我们建议采用低温RFT（60-75°C）治疗TN。脉冲射频（PRF）的治疗效果存在争议，而PRF（≤75°C）与RFT联合使用可改善长期效果并降低并发症发生率。然而，需要大规模临床试验来验证PRF与RFT联合使用的疗效。
