Reduced effect of percutaneous retrogasserian glycerol rhizolysis in trigeminal neuralgia affecting the third branch.
BACKGROUND
The objective of this study was to determine the long-term efficacy of percutaneous glycerol rhizolysis of the trigeminal ganglion for treating patients with trigeminal neuralgia and search for predictors associated with (long-term) benefit to improve patient selection.


METHODS
A retrospective study in 60 consecutive patients treated with percutaneous glycerol rhizolysis of the trigeminal ganglion for trigeminal neuralgia. Charts were reviewed in combination with follow-up by questionnaire (n = 55, 92% response).


RESULTS
Initial pain relief was achieved in 92% of the patients. Pain-free survival was 59% of the patients at 12 months and 53% at 24 months. Most common side effects were hypesthesia (15%), dry eye (5%), and meningitis (2%). In patients without involvement of the third branch of the trigeminal nerve, the initial effect was 79%, of which 90% achieved more than 2 years pain-free survival, compared with 97% initial effect and less than 40% pain-free survival of more than 2 years when the third trigeminal branch was involved.


CONCLUSIONS
The present study demonstrates that involvement of the third branch is a negative predictor for long-term outcome in percutaneous glycerol rhizolysis of the trigeminal ganglion in patients with classical trigeminal neuralgia. However, in the absence of third-branch involvement, glycerol rhizolysis yields excellent long-term results when initial positive effect is obtained.
Mark V
MV
Koning
Nick J
NJ
Koning
Henk M
HM
Koning
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005990:Glycerol / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008340:Mandibular Nerve; D008875:Middle Aged; D059408:Pain Management; D018579:Patient Selection; D012189:Retrospective Studies; D019051:Rhizotomy / Q000379:methods*; D012997:Solvents / Q000627:therapeutic use*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D012668:Trigeminal Ganglion; D014277:Trigeminal Neuralgia / Q000628:therapy*
D012997:Solvents; D005990:Glycerol