Habib Hosam-Eldin Abdel-Azim, Ellakany Mohamed Hamdy, Elnoamany Hossam, Elnaggar Ahmed Gabry
Neurosurgery Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt.
Anesthesia and Pain Management Department, Medical Research Institute, Alexandria University, Alexandria, Egypt.
Asian J Neurosurg. 2024 May 27;19(2):221-227. doi: 10.1055/s-0044-1779516. eCollection 2024 Jun.
Although medical treatment is the mainstay of therapy, in trigeminal neuralgia (TN), patients failing to respond to it make them candidates to ablative or nonablative procedures. The aim of this study was to compare the outcome of Microvascular decompression (MVD) and radiofrequency (RF) thermocoagulation in the management of TN affecting the mandibular and maxillary divisions. Retrospective analysis of the data of 40 patients suffering from intractable classical TN affecting the maxillary or mandibular divisions or both was carried out. Twenty patients were operated upon by MVD of the trigeminal nerve; and 20 had RF ablation of the maxillary or mandibular divisions of the trigeminal nerve or both. In MVD the overall successful outcome was achieved in 16 patients (80%), while the failure was in 4 patients (20%) of which 3 had a fair outcome and 1 patient had a poor outcome. Whereas in RF the overall successful outcome was achieved in 17 patients (85%), while the failure was in 3 patients (15%) of which 2 had a fair outcome and 1 patient had a poor outcome. Outcome was insignificantly different between both groups ( -value 0.806). MVD and RF ablation represent safe and efficacious surgical choices for addressing TN that encompasses both the mandibular and maxillary divisions. Long-term follow-up studies demonstrate that MVD consistently yields favorable outcomes, establishing it as the preferred primary surgical technique, unless contraindicated by the patient's general health and specific needs.
尽管药物治疗是主要的治疗方法，但在三叉神经痛（TN）中，对药物治疗无反应的患者可选择进行消融或非消融手术。本研究的目的是比较微血管减压术（MVD）和射频（RF）热凝术治疗累及下颌支和上颌支的三叉神经痛的效果。对40例患有累及上颌支或下颌支或两者的顽固性典型三叉神经痛患者的数据进行回顾性分析。20例患者接受了三叉神经微血管减压术；20例患者接受了三叉神经上颌支或下颌支或两者的射频消融术。在微血管减压术组中，16例患者（80%）获得了总体成功结果，4例患者（20%）失败，其中3例效果尚可，1例效果较差。而在射频组中，17例患者（85%）获得了总体成功结果，3例患者（15%）失败，其中2例效果尚可，1例效果较差。两组之间的结果差异无统计学意义（P值为0.806）。微血管减压术和射频消融术是治疗累及下颌支和上颌支三叉神经痛的安全有效的手术选择。长期随访研究表明，微血管减压术始终能产生良好的效果，使其成为首选的主要手术技术，除非患者的一般健康状况和特殊需求存在禁忌。
