title: Comparison of nerve combing and percutaneous radiofrequency thermocoagulation in the treatment for idiopathic trigeminal neuralgia.
abstract: BACKGROUND
  Idiopathic trigeminal neuralgia (ITN) is a common pain disease in elderly people. Many methods have been used to alleviate the pain of patients, but few studies in the literature have compared the effect of nerve combing and percutaneous radiofrequency thermocoagulation.
  
  
  OBJECTIVE
  The purpose of this study was to describe and evaluate the clinical outcome of idiopathic trigeminal neuralgia after nerve combing (NC) and compare them with those obtained using percutaneous radiofrequency thermocoagulation (RF).
  
  
  METHODS
  The study included 105 idiopathic trigeminal neuralgia patients with similar symptom, age and underlying disease, which were divided into two groups. One group was treated by nerve combing (50 patients), the other by RF (55 cases). All patients were considered medical failures prior to the surgeries. A questionnaire was used to assess the long-term outcomes: pain relief, recurrence, complication and need for additional treatment.
  
  
  RESULTS
  The median duration of follow-up in both groups was 90 months. Satisfactory relief was noted in 41 patients (82%), 5 patients (10%) initially experienced pain relief, then recurred, and four patients (8%) were designated poor among the group NC. In the group RF, satisfactory relief was noted in 42 patients (76.4%). There were eight "pain free with recurrence patients (14.5%) and 5 poor cases (9.1%). No statistically significant differences existed in the outcomes between both groups (p>0.05). Postoperative morbidity included dysesthesia, diplopia, partial facial nerve palsy, hearing loss, tinnitus, cerebrospinal fluid leak, meningitis and mortality.
  
  
  CONCLUSIONS
  Nerve combing and RF are both satisfactory treatment strategies for patients with ITN. Because of the higher risk of sensory morbidity and surgical risk as open surgery, RF is preferred as the recommended procedure for patients with ITN.
authors.affiliation: Shandong Provincial Hospital Affiliated to Shandong University, Department of Otorhinolaryngology Head and Neck Surgery, Jinan, China.
authors.forename: Xuanchen
authors.initials: X
authors.lastname: Zhou
authors.affiliation: Shandong Provincial Hospital Affiliated to Shandong University, Department of Otorhinolaryngology Head and Neck Surgery, Jinan, China.
authors.forename: Yiqing
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Shandong Provincial Hospital Affiliated to Shandong University, Department of Otorhinolaryngology Head and Neck Surgery, Jinan, China.
authors.forename: Zhiyong
authors.initials: Z
authors.lastname: Yue
authors.affiliation: Shandong Provincial Hospital Affiliated to Shandong University, Department of Otorhinolaryngology Head and Neck Surgery, Jinan, China.
authors.forename: Deheng
authors.initials: D
authors.lastname: Luan
authors.affiliation: Shandong Provincial Hospital Affiliated to Shandong University, Department of Care Gastroenterology, Jinan, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Shandong Provincial Hospital Affiliated to Shandong University, Department of Otorhinolaryngology Head and Neck Surgery, Jinan, China. Electronic address: hanjie64@sohu.com.
authors.forename: Jie
authors.initials: J
authors.lastname: Han
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003399:Craniotomy; D019299:Decompression, Surgical; D004564:Electrocoagulation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D061208:Pulsed Radiofrequency Treatment; D012189:Retrospective Studies; D016896:Treatment Outcome; D014276:Trigeminal Nerve / Q000601:surgery*; D014277:Trigeminal Neuralgia / Q000601:surgery / Q000628:therapy*
keywords: Idiopathic trigeminal neuralgia; Nerve combing; Neuralgia idiopática do trigêmeo; Neurólise interna; Percutaneous radiofrequency; Radiofrequência percutânea
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