Trigeminal Nevraljide Radyofrekans Termokoagülasyon ve Pulse Radyofrekansla Kombine Radyofrekans Termokoagülasyonun Karşılaştırılması

Year 2025, Volume: 26 Issue: 1, 63 - 68, 20.03.2025

Esra Ertilav , Öznur Yıldırım , Osman Nuri Aydın

https://doi.org/10.69601/meandrosmdj.1589421

Abstract

Amaç Bu çalışmanın amacı trigeminal nevraljide etkinliği artırmak için yüksek sıcaklıklarda uygulanan Radyofrekans termokoagülasyon (RFT) ile Pulse Radyofrekans (PRF) kombinasyonlu RFT tedavisini karşılaştırmaktır.
Metod: Mayıs 2014-Mart 2022 tarihleri arasında Algoloji kliniğinde trigeminal nevralji nedeni ile kombine RFT (85°C, 60 saniye) + PRF (42°C, 240 saniye) ve RFT (85°C, 60 saniye) uygulanan hastaların başvurudaki demografik ve klinik muayene bulguları, VAS skorları kaydedildi. İşlem sonrası 1. Ay, 12. Ay ve 24 ay takipte VAS ağrı skorları, klinik ve nörolojik muayene, ağrı kontrol süresi, nüks, gelişen komplikasyon bulguları kaydedildi.
Sonuçlar: 43 hastanın sonuçları (24 kadın, 19 erkek); 20 hastaya yüksek sıcaklıkta RFT, 23 hastaya PRF+RFT uygulanma durumuna göre 2 grupta değerlendirildi. İşlem sonrası 1. Ay, 12. Ay ve 24. Ay takiplerde her iki grupta da VAS skorları işlem öncesine göre anlamlı olarak daha düşüktü (sırasıyla p<0.001, p<0.001). Ağrı kontrol süresi RFT grubunda 25.8±4.8 ay, PRF+RFT grubunda 25±3.4 aydı (p=0.5). 24 ay takipte 3 hastada (2 hasta RFT grubu, 1 hasta PRF+RFT grubu) nüks gözlendi (p=0.5). RFT grubunda 10 hastada, PRF+RFT grubunda 5 hastada komplikasyon (masseter atoni ve dermatomal hipoestezi) vardı (p=0.052). Komplikasyonların gerileme süresi RFT grubunda ortalama 75±35.61 gün, RFT+PRF grubunda ortalama 40±18.17 gündü (p=0.04). Hiçbir hastada geri dönüşümsüz bir komplikasyon kaydedilmedi.
Tartışma: Trigeminal nevraljide yüksek sıcaklıklarda uygulanan RFT ağrı kontrol süresi ve nüks önlemek için etkilidir. Yüksek sıcaklıklarda RFT tedavisine kombine edilen PRF, komplikasyonları önlemek ve yan etki gerileme süresini kısaltmak için uygun bir tedavi seçimidir.

Keywords

Trigeminal nevralji, radyofrekans ablasyon, pulse radyofrekans

Comparison of Radiofrequency Thermocoagulation at High Temperatures with Combined Radiofrequency Thermocoagulation and Pulsed Radiofrequency in the Treatment of Trigeminal Neuralgia

Abstract

Objective: The aim of this study was to compare the Radiofrequency Thermocoagulation (RFT) applied at high temperatures with RFT combined Pulsed Radiofrequency (PRF) to improve the efficacy in trigeminal neuralgia.
Materials and Methods: Demographic, clinical examination findings and VAS scores of the patients who underwent combined RFT + PRF and RFT for trigeminal neuralgia in the Algology clinic between May 2014 and March 2022 were recorded before the procedure and evaluated at 1 month, 12 months and 2 years after the procedure.
Results: The results of 43 patients (24 females, 19 males) were evaluated in 2 groups according to whether 20 patients underwent high-temperature RFT and 23 patients underwent PRF+RFT. At 1 month, 12 months and 24 months post-procedure follow-up, VAS scores were significantly lower in both groups compared to pre-procedure (p<0.001, p<0.001, respectively). The duration of pain control was 25.8±4.8 months in the RFT group and 25±3.4 months in the PRF+RFT group (p=0.5). At 2-year follow-up, recurrence was observed in 3 patients (2 patients in RFT group, 1 patient in PRF+RFT group) (p=0.5). Complications (masseter atony and dermatomal hypoesthesia) occurred in 10 patients in the RFT group and 5 patients in the PRF+RFT group (p=0.052). The mean time to resolution of complications was 75±35.61 days in the RFT group and 40±18.17 days in the RFT+PRF group (p=0.04). No irreversible complication was recorded in any patient.
Conclusion: PRF combined with RFT at high temperatures is an appropriate treatment option to prevent complications and shorten the regression time to side effects.

Keywords

Trigeminal neuralgia, Radiofrequency ablation, Pulse radiofrequency

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