Du Yuanyuan, Liu Xiaohui, Shi Hongchen, Liu Guangzhao, Ren Yue, Xi Lulu
Department of Neurology, Second Hospital of Hebei Medical University, Shijiazhuang, China.
Department of Pain, Second Hospital of Hebei Medical University, Shijiazhuang, China.
Front Neurol. 2025 Jul 8;16:1577399. doi: 10.3389/fneur.2025.1577399. eCollection 2025.
Recurrence of maxillary trigeminal neuralgia (TN) poses a significant clinical challenge. Percutaneous radiofrequency thermocoagulation (PRT) has been established as an effective treatment for maxillary TN. However, the safety and efficacy of different puncture pathways, particularly in the context of pain recurrence, may vary.
This study aimed to compare the safety and efficacy of PRT via the foramen ovale (FO) and pterygopalatine fossa (PF) approaches for recurrent maxillary TN.
This prospective, non-randomized controlled study included 46 patients with recurrent maxillary TN who underwent PRT at our hospital between January 2021 and June 2021. Patients were divided into two groups based on the puncture pathway: the FO group and the PF group. All procedures were performed under local anesthesia and guided by computed tomography (CT). Operative complications were monitored, and pain was assessed using the Visual Analog Scale (VAS) and the Barrow Neurological Institute (BNI) scale. Follow-up evaluations were conducted at 6, 12, 18, and 24 months postoperatively.
The efficacy rates of the two puncture pathways within 24 months were 69.5% (FO group) and 78.2% (PF group), respectively. All patients experienced hypoesthesia in the maxillary nerve area. No severe complications, such as blindness, intracranial hemorrhage, or intracranial infection, were observed in either group.
Both the FO and PF puncture pathways for PRT are safe and effective for treating recurrent maxillary TN. However, for patients with a history of prior PRT or percutaneous balloon compression (PBC) targeting the Gasserian ganglion, the PF approach may be preferable.
上颌三叉神经痛（TN）复发带来了重大的临床挑战。经皮射频热凝术（PRT）已被确立为治疗上颌TN的有效方法。然而，不同穿刺路径的安全性和有效性，尤其是在疼痛复发的情况下，可能会有所不同。
本研究旨在比较经卵圆孔（FO）和翼腭窝（PF）入路的PRT治疗复发性上颌TN的安全性和有效性。
这项前瞻性、非随机对照研究纳入了2021年1月至2021年6月在我院接受PRT的46例复发性上颌TN患者。根据穿刺路径将患者分为两组：FO组和PF组。所有手术均在局部麻醉下进行，并由计算机断层扫描（CT）引导。监测手术并发症，并使用视觉模拟量表（VAS）和巴罗神经学研究所（BNI）量表评估疼痛。术后6、12、18和24个月进行随访评估。
两种穿刺路径在24个月内的有效率分别为69.5%（FO组）和78.2%（PF组）。所有患者上颌神经区域均出现感觉减退。两组均未观察到严重并发症，如失明、颅内出血或颅内感染。
PRT的FO和PF穿刺路径治疗复发性上颌TN均安全有效。然而，对于既往有针对半月神经节的PRT或经皮球囊压迫（PBC）病史的患者，PF入路可能更可取。
