Research Article
BibTex RIS Cite

Efficacy and safety of combined thermocoagulation radiofrequency and pulse radiofrequency in the treatment of trigeminal neuralgia

Year 2023, Volume: 4 Issue: 4, 252 - 257, 30.08.2023
https://doi.org/10.47582/jompac.1303163

Abstract

Aims: The aim of this study was to evaluate the efficacy and safety of radiofrequency thermocoagulation (RFT) combined with pulsed radiofrequency (PRF) of the Gasserian ganglion in patients with V2/V3 trigeminal neuralgia (TN).
Methods: We evaluated 27 patients with V2/3 TN who had undergone combined RFT and PRF of the Gasserian ganglion. Patients were treated with PRF (42°C, 45 V, 20 ms, 120 s), RFT (65°C, 60 s), RFT (70°C, 60 s), and PRF (42°C, 45 V, 20 ms, 120 s), consecutively. Visual analogue scale (VAS) and Barrow Neurological Institute Pain Intensity Scale (BNI) scores were evaluated before and after (1st month, 6th month, and 12th month) the procedure. A BNI score of 1-3 was considered as an effective treatment, while a BNI score of 4 or 5 indicated unsuccessful treatment.
Results: VAS scores were significantly lower than the baseline values in all post-treatment evaluation visits (1st month, 6th month, 12th month) during the 12-month follow-up period (p<0.001). After treatment, 26 patients (96.2%) at 1 month, 25 patients (92.5%) at 6 months, and 20 patients (74%) at 12 months had BNI scores of 1-3. No association was found between improvement in BNI and variables such as age, gender, duration of pain, TN side, affected branch, or pre-treatment VAS scores (p>0.05).
Conclusion: Combined RFT and PRF to the Gasserian ganglion is a safe and effective therapeutic approach in the treatment of TN. However, its efficacy partially decreases after one year.

References

  • Arnold M. Headache classification committee of the international headache society (IHS) the international classification of headache disorders. Cephalalgia. 2018;38(1):1-211.
  • Zakrzewska JM, Linskey ME. Trigeminal neuralgia. BMJ. 2014;348:474.
  • Van Hecke O, Austin SK, Khan RA, Smith B, Torrance N. Neuropathic pain in the general population: a systematic review of epidemiological studies. PAIN®. 2014;155(4):654-662.
  • Bharti N, Sujith J, Singla N, Panda NB, Bala I. Radiofrequency thermoablation of the Gasserian ganglion versus the peripheral branches of the trigeminal nerve for treatment of trigeminal neuralgia: a randomized, control trial. Pain Physician. 2019;22(2):147.
  • Van Zundert J, Patijn J, Hartrick C, Lataster A, Huygen F, Mekhail N. Evidence-based interventional pain medicine: according to clinical diagnoses. Pain Pract. 2011;11:423–429.
  • Hitchon PW, Holland M, Noeller J, et al. Options in treating trigeminal neuralgia: experience with 195 patients. Clin Neurol Neurosurg. 2016;149:166–170.
  • Thapa D, Ahuja V, Dass C, Verma P. Management of refractory trigeminal neuralgia using extended duration pulsed radiofrequency application. Pain Physician. 2015;18:E433-E435.
  • Vanneste T, Van Lantschoot A, Van Boxem K, Van Zundert J. Pulsed radiofrequency in chronic pain. Curr Opin Anaesthesiol. 2017;30(5):577-582.
  • Sridharan K, Sivaramakrishnan G. Interventions for refractory trigeminal neuralgia: a bayesian mixed treatment comparison network meta-analysis of randomized controlled clinical trials. Clin Drug Investig. 2017;37(9):819-831.
  • Fang L, Ying S, Tao W, Lan M, Xiaotong Y, Nan J. 3 D CT‐Guided Pulsed Radiofrequency Treatment for Trigeminal Neuralgia. Pain Pract. 2014;14(1):16-21.
  • Fang L, Tao W, Jingjing L, Nan J. Comparison of high‐voltage‐with standard‐voltage pulsed 2015;15(7):595-603.
  • Arici T, Kurcaloglu M, Kilic E, Erhan E. Radiofrequency thermocoagulation combined with pulsed radiofrequency for gasserian ganglion blockage. Agri. 2018;30:179-182.
  • Ren H, Zhao C, Wang X, Shen Y, Meng L, Luo F. The efficacy and safety of the application of pulsed radiofrequency, combined with low-temperature continuous radiofrequency, to the Gasserian ganglion for the treatment of primary trigeminal neuralgia: study protocol for a prospective, open-label, parall. Pain Physician. 2021;24(1):89.
  • Elawamy A, Abdalla EEM, Shehata GA. Effects of pulsed versus conventional versus combined radiofrequency for the treatment of trigeminal neuralgia: a prospective study. Pain Physician. 2017;20(6):E873.
  • Kanpolat Y, Savas A, Bekar A, Berk C. Percutaneous controlled radiofrequency trigeminal rhizotomy for the treatment of idiopathic trigeminal neuralgia: 25-year experience with 1600 patients. Neurosurg. 2001;48(3):524-534.
  • Gunduz HB, Cevik OM, Asilturk M, et al. Percutaneous Radiofrequency Thermocoagulation in Trigeminal Neuralgia: Analysis of Early and Late Outcomes of 156 Cases and 209 Interventions. J Korean Neurosurg Soc. 2021;64(5):827-836.
  • Zhou X, Liu Y, Yue Z, Luan D, Zhang H, Han J. Comparison of nerve combing and percutaneous radiofrequency thermocoagulation in the treatment for idiopathic trigeminal neuralgia. Braz J Otorhinolaryngol. 2016;82:574-579.
  • Tang Y-Z, Jin D, Bian J-J, Li X-Y, Lai G-H, Ni J-X. Long-term outcome of computed tomography–guided percutaneous radiofrequency Thermocoagulation for classic trigeminal neuralgia patients older than 70 years. J Craniofac Surg. 2014;25(4):1292-1295.
  • Wu H, Zhou J, Chen J, Gu Y, Shi L, Ni H. Therapeutic efficacy and safety of radiofrequency ablation for the treatment of trigeminal neuralgia: a systematic review and meta-analysis. J Pain Res. 2019;12:423.
  • Mathews ES, Scrivani SJ. Percutaneous stereotactic radiofrequency thermal rhizotomy for the treatment of trigeminal neuralgia. Mt Sinai J Med. 2000;67(4):288-299.
  • Cahana A, Van Zundert J, Macrea L, Van Kleef M, Sluijter M. Pulsed radiofrequency: current clinical and biological literature available. Pain Med. 2006;7(5):411-423.
  • Rehman S, Khan M, Hussain R, Jamshed A. Pulsed radiofrequency modulation for lingual neuralgia. Br J Oral Maxillofac Surg. 2012;50(1):e4-e5.
  • Cosman Jr ER, Cosman Sr ER. Electric and thermal field effects in tissue around radiofrequency electrodes. Pain Med. 2005;6(6):405-424.
  • Bogduk N. Pulsed radiofrequency. Pain Med. 2006;7(5):396-407.
  • Chua NHL, Halim W, Beems T, Vissers KC. Pulsed radiofrequency treatment for trigeminal neuralgia. Anesth Pain Med. 2012;1(4):257.
  • Erdine S, Ozyalcin NS, Cimen A, Celik M, Talu GK, Disci R. Comparison of pulsed radiofrequency with conventional radiofrequency in the treatment of idiopathic trigeminal neuralgia. Eur J Pain. 2007;11(3):309-313.
  • Ali Eissa AA, Reyad RM, Saleh EG, El-Saman A. The efficacy and safety of combined pulsed and conventional radiofrequency treatment of refractory cases of idiopathic trigeminal neuralgia: a retrospective study. J Anesth. 2015;29(5):728-733.
  • Ding Y, Li H, Hong T, Zhu Y, Yao P, Zhou G. Combination of pulsed radiofrequency with continuous radiofrequency thermocoagulation at low temperature improves efficacy and safety in V2/V3 primary trigeminal neuralgia. Pain Physician. 2018;21(5):E545.
  • Abdel‐Rahman KA, Elawamy AM, Mostafa MF, et al. Combined pulsed and thermal radiofrequency versus thermal radiofrequency alone in the treatment of recurrent trigeminal neuralgia after microvascular decompression: a double blinded comparative study. Eur J Pain. 2020;24(2):338-345.
  • Tanaka N, Yamaga M, Tateyama S, Uno T, Tsuneyoshi I, Takasaki M. The effect of pulsed radiofrequency current on mechanical allodynia induced with resiniferatoxin in rats. Anesth Analg. 2010;111(3):784-790.
  • Zhao W, Wang Q, He M, Yang L, Wu B, Ni J. Radiofrequency thermocoagulation combined with pulsed radiofrequency helps relieve postoperative complications of trigeminal neuralgia. Genet Mol Res. 2015;14(3):7616-7623.

V2/3 trigeminal nevraljide termokoagulasyon radyofrekansın pulse radyofrekans ile kombine edilmesinin etkinlik ve güvenliği

Year 2023, Volume: 4 Issue: 4, 252 - 257, 30.08.2023
https://doi.org/10.47582/jompac.1303163

Abstract

Amaç: V2/V3 trigeminal nevraljide (TN) gasser gangliona radyofrekans termokoagülasyonun (RFT) pulse radyofrekans (PRF) ile kombine olarak uygulanmasının etkililik ve güvenliğini değerlendirmek amaçlandı.
Gereç ve Yöntemler: Gasser gangliona kombine RFT ve PRF tedavisi uygulanmış 27 V2/3 TN'li hasta değerlendirildi. Hastalara sırasıyla PRF (42°C, 45V, 20 ms, 120 saniye), RFT (65 °C, 60 saniye), RFT (70 °C, 60 saniye), PRF (42°C, 45V, 20 ms, 120 saniye) uygulandı. Hastaların işlem öncesi ve sonrası (1.ay, 6. ay, 12. ay) Visual Analog Skala (VAS) ve Barrow Neurolgical Institute Ağrı Yoğunluk Skalası (BNI) skorları değerlendirildi. BNI skorunun 1 ila 3 arasında olması etkili tedavi olarak, BNI skorunun 4 ya da 5 olması ise başarısız tedavi olarak kabul edildi.
Bulgular: VAS skorları, 12 ay izlem dönemince tedavi sonrası tüm değerlendirme sürelerinde (1. ay, 6. ay, 12. ay) başlangıç değerine kıyasla anlamlı olarak daha düşüktü (p<0,001). Tedavi sonrası 1. ayda 26 hasta (% 96,2), 6. ayda 25 (% 92,5) hasta, 12. ayda 20 (%74) hastanın BNI skorları 1-3 arasında idi. BNI'deki iyileşme ile yaş, cinsiyet, ağrı süresi, TN tarafı, etkilenen dal ve işlem öncesi VAS skoru arasında bir ilişki bulunamadı. (p>0,05).
Sonuç: Gasser gangliona uygulanan kombine RFT+PRF TN tedavisinde güvenli ve etkili bir tedavidir. Ancak tedaviden 1 yıl sonra tedavinin etkinliği kısmen azalır.

References

  • Arnold M. Headache classification committee of the international headache society (IHS) the international classification of headache disorders. Cephalalgia. 2018;38(1):1-211.
  • Zakrzewska JM, Linskey ME. Trigeminal neuralgia. BMJ. 2014;348:474.
  • Van Hecke O, Austin SK, Khan RA, Smith B, Torrance N. Neuropathic pain in the general population: a systematic review of epidemiological studies. PAIN®. 2014;155(4):654-662.
  • Bharti N, Sujith J, Singla N, Panda NB, Bala I. Radiofrequency thermoablation of the Gasserian ganglion versus the peripheral branches of the trigeminal nerve for treatment of trigeminal neuralgia: a randomized, control trial. Pain Physician. 2019;22(2):147.
  • Van Zundert J, Patijn J, Hartrick C, Lataster A, Huygen F, Mekhail N. Evidence-based interventional pain medicine: according to clinical diagnoses. Pain Pract. 2011;11:423–429.
  • Hitchon PW, Holland M, Noeller J, et al. Options in treating trigeminal neuralgia: experience with 195 patients. Clin Neurol Neurosurg. 2016;149:166–170.
  • Thapa D, Ahuja V, Dass C, Verma P. Management of refractory trigeminal neuralgia using extended duration pulsed radiofrequency application. Pain Physician. 2015;18:E433-E435.
  • Vanneste T, Van Lantschoot A, Van Boxem K, Van Zundert J. Pulsed radiofrequency in chronic pain. Curr Opin Anaesthesiol. 2017;30(5):577-582.
  • Sridharan K, Sivaramakrishnan G. Interventions for refractory trigeminal neuralgia: a bayesian mixed treatment comparison network meta-analysis of randomized controlled clinical trials. Clin Drug Investig. 2017;37(9):819-831.
  • Fang L, Ying S, Tao W, Lan M, Xiaotong Y, Nan J. 3 D CT‐Guided Pulsed Radiofrequency Treatment for Trigeminal Neuralgia. Pain Pract. 2014;14(1):16-21.
  • Fang L, Tao W, Jingjing L, Nan J. Comparison of high‐voltage‐with standard‐voltage pulsed 2015;15(7):595-603.
  • Arici T, Kurcaloglu M, Kilic E, Erhan E. Radiofrequency thermocoagulation combined with pulsed radiofrequency for gasserian ganglion blockage. Agri. 2018;30:179-182.
  • Ren H, Zhao C, Wang X, Shen Y, Meng L, Luo F. The efficacy and safety of the application of pulsed radiofrequency, combined with low-temperature continuous radiofrequency, to the Gasserian ganglion for the treatment of primary trigeminal neuralgia: study protocol for a prospective, open-label, parall. Pain Physician. 2021;24(1):89.
  • Elawamy A, Abdalla EEM, Shehata GA. Effects of pulsed versus conventional versus combined radiofrequency for the treatment of trigeminal neuralgia: a prospective study. Pain Physician. 2017;20(6):E873.
  • Kanpolat Y, Savas A, Bekar A, Berk C. Percutaneous controlled radiofrequency trigeminal rhizotomy for the treatment of idiopathic trigeminal neuralgia: 25-year experience with 1600 patients. Neurosurg. 2001;48(3):524-534.
  • Gunduz HB, Cevik OM, Asilturk M, et al. Percutaneous Radiofrequency Thermocoagulation in Trigeminal Neuralgia: Analysis of Early and Late Outcomes of 156 Cases and 209 Interventions. J Korean Neurosurg Soc. 2021;64(5):827-836.
  • Zhou X, Liu Y, Yue Z, Luan D, Zhang H, Han J. Comparison of nerve combing and percutaneous radiofrequency thermocoagulation in the treatment for idiopathic trigeminal neuralgia. Braz J Otorhinolaryngol. 2016;82:574-579.
  • Tang Y-Z, Jin D, Bian J-J, Li X-Y, Lai G-H, Ni J-X. Long-term outcome of computed tomography–guided percutaneous radiofrequency Thermocoagulation for classic trigeminal neuralgia patients older than 70 years. J Craniofac Surg. 2014;25(4):1292-1295.
  • Wu H, Zhou J, Chen J, Gu Y, Shi L, Ni H. Therapeutic efficacy and safety of radiofrequency ablation for the treatment of trigeminal neuralgia: a systematic review and meta-analysis. J Pain Res. 2019;12:423.
  • Mathews ES, Scrivani SJ. Percutaneous stereotactic radiofrequency thermal rhizotomy for the treatment of trigeminal neuralgia. Mt Sinai J Med. 2000;67(4):288-299.
  • Cahana A, Van Zundert J, Macrea L, Van Kleef M, Sluijter M. Pulsed radiofrequency: current clinical and biological literature available. Pain Med. 2006;7(5):411-423.
  • Rehman S, Khan M, Hussain R, Jamshed A. Pulsed radiofrequency modulation for lingual neuralgia. Br J Oral Maxillofac Surg. 2012;50(1):e4-e5.
  • Cosman Jr ER, Cosman Sr ER. Electric and thermal field effects in tissue around radiofrequency electrodes. Pain Med. 2005;6(6):405-424.
  • Bogduk N. Pulsed radiofrequency. Pain Med. 2006;7(5):396-407.
  • Chua NHL, Halim W, Beems T, Vissers KC. Pulsed radiofrequency treatment for trigeminal neuralgia. Anesth Pain Med. 2012;1(4):257.
  • Erdine S, Ozyalcin NS, Cimen A, Celik M, Talu GK, Disci R. Comparison of pulsed radiofrequency with conventional radiofrequency in the treatment of idiopathic trigeminal neuralgia. Eur J Pain. 2007;11(3):309-313.
  • Ali Eissa AA, Reyad RM, Saleh EG, El-Saman A. The efficacy and safety of combined pulsed and conventional radiofrequency treatment of refractory cases of idiopathic trigeminal neuralgia: a retrospective study. J Anesth. 2015;29(5):728-733.
  • Ding Y, Li H, Hong T, Zhu Y, Yao P, Zhou G. Combination of pulsed radiofrequency with continuous radiofrequency thermocoagulation at low temperature improves efficacy and safety in V2/V3 primary trigeminal neuralgia. Pain Physician. 2018;21(5):E545.
  • Abdel‐Rahman KA, Elawamy AM, Mostafa MF, et al. Combined pulsed and thermal radiofrequency versus thermal radiofrequency alone in the treatment of recurrent trigeminal neuralgia after microvascular decompression: a double blinded comparative study. Eur J Pain. 2020;24(2):338-345.
  • Tanaka N, Yamaga M, Tateyama S, Uno T, Tsuneyoshi I, Takasaki M. The effect of pulsed radiofrequency current on mechanical allodynia induced with resiniferatoxin in rats. Anesth Analg. 2010;111(3):784-790.
  • Zhao W, Wang Q, He M, Yang L, Wu B, Ni J. Radiofrequency thermocoagulation combined with pulsed radiofrequency helps relieve postoperative complications of trigeminal neuralgia. Genet Mol Res. 2015;14(3):7616-7623.
There are 31 citations in total.

Details

Primary Language English
Subjects Neurology and Neuromuscular Diseases, Health Care Administration
Journal Section Research Articles [en] Araştırma Makaleleri [tr]
Authors

Samet Sancar Kaya 0000-0003-4819-1128

Şeref Çelik 0000-0003-2360-0714

Yavuz Akçaboy 0000-0002-9962-2090

Publication Date August 30, 2023
Published in Issue Year 2023 Volume: 4 Issue: 4

Cite

AMA Kaya SS, Çelik Ş, Akçaboy Y. Efficacy and safety of combined thermocoagulation radiofrequency and pulse radiofrequency in the treatment of trigeminal neuralgia. J Med Palliat Care / JOMPAC / jompac. August 2023;4(4):252-257. doi:10.47582/jompac.1303163

TR DİZİN ULAKBİM and International Indexes (1d)

Interuniversity Board (UAK) Equivalency: Article published in Ulakbim TR Index journal [10 POINTS], and Article published in other (excuding 1a, b, c) international indexed journal (1d) [5 POINTS]



google-scholar.png


crossref.jpg

f9ab67f.png

asos-index.png


COPE.jpg

icmje_1_orig.png

cc.logo.large.png

ncbi.png

ORCID_logo.png

pn6krf5.jpg


Our journal is in TR-Dizin, DRJI (Directory of Research Journals Indexing, General Impact Factor, Google Scholar, Researchgate, CrossRef (DOI), ROAD, ASOS Index, Turk Medline Index, Eurasian Scientific Journal Index (ESJI), and Turkiye Citation Index.

EBSCO, DOAJ, OAJI and ProQuest Index are in process of evaluation. 

Journal articles are evaluated as "Double-Blind Peer Review"