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conferenceseries.com
Volume 6, Issue 5 (Suppl) J Pain Relief, an open access journal
ISSN: 2167-0846 Pain Management 2017
October 05-06, 2017
5th International Conference and Exhibition on
October 05-06, 2017 London, UK
Pain Research And Management
Trigeminal neuralgia: Radiofrequency treatment, glycerol rhyzolysis or surgery?
Henk M Koning
Pain Clinic De Bilt, The Netherlands
Trigeminal neuralgia (TN) is a painful condition involving the face which can be severely disabling. Several types of invasive
(percutaneous treatments, surgical procedures) treatments are available. None of these treatments have been shown to be
superior due to a lack of well-designed randomized controlled trials and conflicting results in the literature on observational
studies regarding TN. Radiofrequency (RF) treatment is a minimally invasive, low-risk technique with a high rate of initial
efficacy for treating TN and with high rates of side effects. Between 85% and 97% of patients report an initial effect of the RF
ablation of the trigeminal ganglion. Pain recurrence rates are between 25% and 60%. Its disadvantages, however, include a
high incidence of side-effects, large variability of effects and side effects, and a high rate of long-term failure. Empirical data
on sensory stimulation thresholds, lesion time, and temperature during RF treatment, which could support making the most
effective selection from the treatment options currently available, are lacking. Our study shows that there may be an optimum
of sensory stimulation levels at 50 Hz during RF treatment of the trigeminal ganglion. Glycerol rhizolysis of the trigeminal
ganglion is a safe procedure, which achieves a high rate of immediate initial pain relief with little or no alteration in facial
sensory function in patients with trigeminal neuralgia. Earlier studies reported a success-rate between 59% and 94%. The
reported recurrence rate at the end of 2 years after percutaneous glycerol rhizolysis of the trigeminal ganglion for trigeminal
neuralgia is 39-41%. In the patient group with classical trigeminal neuralgia without third branch involvement, glycerol
rhizolysis seems to be a highly appropriate percutaneous procedure. A prospective study on whether patient selection could
improve the outcome of percutaneous treatments of trigeminal neuralgia is warranted. Further investigation of an optimal
sensory stimulation range and an optimal temperature for percutaneous RF treatment of the trigeminal ganglion is advocated.
Biography
Henk M Koning is an Anesthesiologist who worked more than 30 years in multidisciplinary pain relief. He has several national and international publications
concerning anesthesiology, intensive care, trauma care and pain. In pain, his expertise is: low back pain, cervical pain, trigeminal neuralgia, painful feet, and
tinnitus. He works in the Pain Clinic De Bilt, De Bilt, Netherlands.
Henk M Koning, J Pain Relief 2017, 6:5(Suppl)
DOI: 10.4172/2167-0846-C1-014