Three-dimensional computed tomography-guided radiofrequency trigeminal rhizotomy for treatment of idiopathic trigeminal neuralgia.
OBJECTIVE
To evaluate the effectiveness of three-dimensional computed tomography (3D-CT) guided radiofrequency trigeminal rhizotomy (RF-TR) in treatment of idiopathic trigeminal neuralgia (ITN).


METHODS
From 1999 to 2001, 18 patients with ITN were treated with percutaneous controlled RF-TR. Intraoperative 3D-CT scanning was performed to guide the trajectory of the puncture. After correction of the needle tip according to the CT scans and stimulation effects, 2 to 5 lesions were made for a duration of 60-90 seconds at a temperature of 60 degrees C to 75 degrees C depending on the pain distribution and the age of patient.


RESULTS
The needles located in foramen ovale. Pain alleviated immediately with no serious complication in all patients. The patients were followed up for an average of 31.5 months (range 24-41 months). Acute pain relief was experienced by 17 patients after the procedure, reaching an initial success rate of 94.4%. Early (< 6 months) pain recurrence was observed in 2 patients (11.1%), whereas late (> 6 months) recurrence was reported in 3 patients (16.7%). Thirteen patients had complete pain control, with no need for medication thereafter. Five cases experienced partial pain relief, but required medication at a lower dose than in the preoperative period.


CONCLUSIONS
3D-CT foramen ovale locations can raise the successful rate of puncture, enhance the safety, and reduce the incidence rate of complication.
Liu
Meng
M
Department of Neurosurgery, Qilu Hospital, Shandong University, Jinan 250012. liumengqilu@vip.sina.com
Wu
Cheng-Yuan
CY
Liu
Yu-Guang
YG
Wang
Hong-Wei
HW
Meng
Fan-Gang
FG
D000328:Adult; D000368:Aged; D017115:Catheter Ablation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D019051:Rhizotomy / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome; D014277:Trigeminal Neuralgia / Q000000981:diagnostic imaging / Q000601:surgery*