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The Long-Term Outcome of 3-Dimensional CT-Guided Percutaneous Radiofrequency Thermocoagulation for Tumor-Related Trigeminal Neuralgia.

BACKGROUND
Percutaneous radiofrequency thermocoagulation (PRFT) has been widely used to treat trigeminal neuralgia. By querying MEDLINE, EMBASE, and the Cochrane Library, no study has reported the long-term outcome of PRFT for tumor-related trigeminal neuralgia (TRTN).


OBJECTIVES
In this study, we aimed to evaluate the long-term efficacy and safety of PRFT as an alternative treatment for TRTN.


STUDY DESIGN
A retrospective study.


SETTING
The interventional pain management center in Beijing Tiantan hospital.


METHODS
We retrospectively analyzed data of all patients who underwent PRFT applied to the Gasserian ganglion under computed tomography guidance for TRTN through a combination of available institutional electronic medical records, patient notes, and radiologic images.


RESULTS
Among 38 patients with PRFT treated between March 2007 and February 2018, 13 patients were men and 25 were women. All patients were evaluated as modified Barrow Neurological Institute (BNI) IV-V before the operation and had a total symptom duration of 45.55 ± 23.31 months. The mean operation duration was 59.63 ± 16.89 minutes. All patients experienced satisfactory pain relief defined as a classification of BNI I-IIIb within 3 days after PRFT. The median remission length with satisfactory pain relief was 33 (range, 4-132) months. No serious intraoperative complications, except bradycardia in 6 patients, were recorded. Postprocedure complications, including masticatory muscle weakness, were reported in 5 patients. Although all 38 patients experienced facial dysesthesia, the patients' Likert scale rating represented that quality of life significantly increased after the procedure.


LIMITATIONS
The small sample size may have unavoidably caused selection bias in our study. Larger prospective, randomized, multicenter trials are necessary to validate our outcomes.


CONCLUSIONS
PRFT is an effective and safe treatment that should be considered as an alternative for pain control in the treatment of TRTN.


KEY WORDS
Pain, secondary trigeminal neuralgia, radiofrequency thermocoagulation, trigeminal neuralgia.