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

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.

Keywords

• Trigeminal nevralji
• Gasser ganglion
• pulse radyofrekans
• radyofrekans termokoagülasyon

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

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.

Keywords

• Trigeminal neuralgia
• Gasserian ganglion
• pulse radiofrequency
• radiofrequency thermocoagulation

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