Percutaneous radiofrequency rhizotomy and neurovascular decompression of the trigeminal nerve for the treatment of facial pain.
OBJECTIVE
To determine the outcomes of 354 radiofrequency rhizotomies and 21 neurovascular decompressions performed as treatment for 367 facial pain patients (290 idiopathic trigeminal neuralgia, 52 symptomatic trigeminal neuralgia, 16 atypical facial pain, 9 post-herpetic neuralgia).


METHODS
Clinical findings and surgery success rate were considered for evaluation. A scale of success rate was determined to classify patients, which considered pain relief and functional/sensorial deficits.


RESULTS
Radiofrequency rhizotomy was performed in 273 patients with idiopathic trigeminal neuralgia and in all other patients, except for trigeminal neuropathy; neurovascular decompression was performed in 18 idiopathic trigeminal neuralgia patients; 100% idiopathic trigeminal neuralgia, 96.2% symptomatic trigeminal neuralgia, 37.5% atypical facial pain and 88.9% post-herpetic neuralgia had pain relief.


CONCLUSIONS
Both techniques for idiopathic trigeminal neuralgia are usefull. Radiofrequency rhizotomy was also efficient to treat symptomatic facial pain, and post-herpetic facial pain, but is not a good technique for atypical facial pain.
Teixeira
Manoel J
MJ
Pain Center of Hospital das Clinicas, Functional Neurosurgery Division, Neurology Department, Medical School, University of São Paulo SP, Brazil.
Siqueira
Silvia R D T
SR
Almeida
Gilberto M
GM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017115:Catheter Ablation; D019299:Decompression, Surgical / Q000379:methods*; D005157:Facial Pain / Q000209:etiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D019051:Rhizotomy / Q000379:methods*; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014277:Trigeminal Neuralgia / Q000601:surgery*