Analyzing the Effect of Intraoperative Stimulation Voltage on Facial Numbness Following Radiofrequency Thermocoagulation in the Treatment of Idiopathic Trigeminal Neuralgia.

Electric stimulation Neuralgia Numbness Radiofrequency ablation Trigeminal nerve disease Voltage

Journal

Pain and therapy
ISSN: 2193-8237
Titre abrégé: Pain Ther
Pays: New Zealand
ID NLM: 101634491

Informations de publication

Date de publication:
15 Mar 2024
Historique:
received: 02 01 2024
accepted: 19 02 2024
medline: 15 3 2024
pubmed: 15 3 2024
entrez: 15 3 2024
Statut: aheadofprint

Résumé

Radiofrequency thermocoagulation (RFT) effectively alleviates idiopathic trigeminal neuralgia (ITN); however, postoperative facial numbness poses a significant challenge. This issue arises due to the close proximity of high-temperature thermocoagulation, which not only ablates pain-related nociceptive fibers but also affects tactile fibers. Intraoperative sensory stimulation voltage (SV), which reflects the distance between the RFT cannula and the target nerve, potentially possesses the ability to prevent tactile fiber injury. This study aimed to investigate the influence of SV on postoperative facial numbness and provide valuable insights to mitigate its occurrence. A retrospective analysis was performed on 72 ITN patients with maxillary division (V2) pain who underwent RFT between 2020 and 2022. Among them, 13 patients with SV ≤ 0.2 V constituted the low SV group. Subsequently, a matched-cohort analysis was conducted on the remaining 59 patients. The patients paired with the low SV patients were subsequently enrolled in the high SV group, adhering to a 1:1 match ratio. The primary outcome was the facial numbness scale assessment at 3 days, 3 months and 6 months post-surgery. The pain intensity and medication burden served as the secondary outcomes. We successfully matched a cohort consisting of 12 patients in the low SV group and 12 patients in the high SV group. Each patient experienced various degrees of facial numbness at 3 days post-RFT. Notably, the low SV group exhibited a higher incidence of moderate numbness (66.7% vs. 16.67%, P = 0.036), whereas the high SV group had more cases of mild numbness at the 6-month follow-up (25% vs. 83.3%, P = 0.012). Both groups demonstrated significant decreases in pain intensity and medication burden compared to before the operation. SV proved to be a reliable parameter for mitigating the degree of postoperative facial numbness in RFT treatment for ITN. A relatively high sensory SV ranging from 0.3 to 0.6 V during the RFT procedure results in less facial numbness in the treatment of ITN.

Identifiants

pubmed: 38489096
doi: 10.1007/s40122-024-00587-5
pii: 10.1007/s40122-024-00587-5
doi:

Types de publication

Journal Article

Langues

eng

Informations de copyright

© 2024. The Author(s).

Références

Zakrzewska JM, McMillan R. Trigeminal neuralgia: the diagnosis and management of this excruciating and poorly understood facial pain. Postgrad Med J. 2011;87(1028):410–6.
pubmed: 21493636 doi: 10.1136/pgmj.2009.080473
Cruccu G, Gronseth G, Alksne J, Argoff C, Brainin M, Burchiel K, et al. AAN-EFNS guidelines on trigeminal neuralgia management. Eur J Neurol. 2008;15(10):1013–28.
pubmed: 18721143 doi: 10.1111/j.1468-1331.2008.02185.x
Koopman JS, Dieleman JP, Huygen FJ, de Mos M, Martin CG, Sturkenboom MC. Incidence of facial pain in the general population. Pain. 2009;147(1–3):122–7.
pubmed: 19783099 doi: 10.1016/j.pain.2009.08.023
Dieleman JP, Kerklaan J, Huygen F, Bouma PAD, Sturkenboom M. Incidence rates and treatment of neuropathic pain conditions in the general population. Pain. 2008;137(3):681–8.
pubmed: 18439759 doi: 10.1016/j.pain.2008.03.002
Bendtsen L, Zakrzewska JM, Abbott J, Braschinsky M, Di Stefano G, Donnet A, et al. European Academy of Neurology guideline on trigeminal neuralgia. Eur J Neurol. 2019;26(6):831–49.
Zakrzewska JM, Lopez BC, Kim SE, Coakham HB. Patient reports of satisfaction after microvascular decompression and partial sensory rhizotomy for trigeminal neuralgia. Neurosurgery. 2005;56(6):1304–11.
pubmed: 15918947 doi: 10.1227/01.NEU.0000159883.35957.E0
Al-Quliti KW. Update on neuropathic pain treatment for trigeminal neuralgia. The pharmacological and surgical options. Neurosciences (Riyadh). 2015;20(2):107–14.
pubmed: 25864062 doi: 10.17712/nsj.2015.2.20140501
Howard SD, Soti V. How far has radiofrequency thermocoagulation come along as a treatment procedure in treating trigeminal neuralgia patients? Cureus. 2023;15(6): e40311.
pubmed: 37313286 pmcid: 10259628
Chong MS, Bahra A, Zakrzewska JM. Guidelines for the management of trigeminal neuralgia. Cleve Clin J Med. 2023;90(6):355–62.
pubmed: 37263669 doi: 10.3949/ccjm.90a.22052
Emril DR, Ho KY. Treatment of trigeminal neuralgia: role of radiofrequency ablation. J Pain Res. 2010;3:249–54.
pubmed: 21311718 pmcid: 3033033
Taha JM, Tew JM Jr. Comparison of surgical treatments for trigeminal neuralgia: reevaluation of radiofrequency rhizotomy. Neurosurgery. 1996;38(5):865–71.
pubmed: 8727810 doi: 10.1097/00006123-199605000-00001
Tang YZ, Wu BS, Yang LQ, Yue JN, He LL, Li N, et al. The long-term effective rate of different branches of idiopathic trigeminal neuralgia after single radiofrequency thermocoagulation: a cohort study. Medicine (Baltimore). 2015;94(45): e1994.
pubmed: 26559288 doi: 10.1097/MD.0000000000001994
Tang YZ, Jin D, Bian JJ, Li XY, Lai GH, Ni JX. Long-term outcome of computed tomography-guided percutaneous radiofrequency thermocoagulation for classic trigeminal neuralgia patients older than 70 years. J Craniofac Surg. 2014;25(4):1292–5.
pubmed: 25006910 doi: 10.1097/SCS.0000000000000591
Hong T, Ding Y, Yao P. Long-term efficacy and complications of radiofrequency thermocoagulation at different temperatures for the treatment of trigeminal neuralgia. Biochem Res Int. 2020;2020:3854284.
pubmed: 32211206 pmcid: 7077036 doi: 10.1155/2020/3854284
Letcher FS, Goldring S. The effect of radiofrequency current and heat on peripheral nerve action potential in the cat. J Neurosurg. 1968;29(1):42–7.
pubmed: 5674091 doi: 10.3171/jns.1968.29.1.0042
Frigyesi TL, Siegfried J, Broggi G. The selective vulnerability of evoked potentials in the trigeminal sensory root of graded thermocoagulation. Exp Neurol. 1975;49(1 Pt 1):11–21.
pubmed: 1183519 doi: 10.1016/0014-4886(75)90192-2
Mittal B, Thomas DG. Controlled thermocoagulation in trigeminal neuralgia. J Neurol Neurosurg Psychiatry. 1986;49(8):932–6.
pubmed: 3746327 pmcid: 1028956 doi: 10.1136/jnnp.49.8.932
Kanpolat Y, Savas A, Bekar A, Berk C. Percutaneous controlled radiofrequency trigeminal rhizotomy for the treatment of idiopathic trigeminal neuralgia: 25-year experience with 1600 patients. Neurosurgery. 2001;48(3):524–32.
pubmed: 11270542 doi: 10.1097/00006123-200103000-00013
Sekimoto K, Koizuka S, Saito S, Goto F. Thermogangliolysis of the Gasserian ganglion under computed tomography fluoroscopy. J Anesth. 2005;19(2):177–9.
pubmed: 15875140 doi: 10.1007/s00540-005-0307-3
Tang YZ, Yang LQ, Yue JN, Wang XP, He LL, Ni JX. The optimal radiofrequency temperature in radiofrequency thermocoagulation for idiopathic trigeminal neuralgia: a cohort study. Medicine (Baltimore). 2016;95(28): e4103.
pubmed: 27428194 doi: 10.1097/MD.0000000000004103
Yao P, Deng YY, Hong T, Wang ZB, Ma JM, Zhu YQ, et al. Radiofrequency thermocoagulation for V2/V3 idiopathic trigeminal neuralgia: effect of treatment temperatures on long-term clinical outcomes: a cohort study. Medicine (Baltimore). 2016;95(26): e4019.
pubmed: 27368021 doi: 10.1097/MD.0000000000004019
Yao P, Hong T, Wang ZB, Ma JM, Zhu YQ, Li HX, et al. Treatment of bilateral idiopathic trigeminal neuralgia by radiofrequency thermocoagulation at different temperatures. Medicine (Baltimore). 2016;95(29): e4274.
pubmed: 27442662 doi: 10.1097/MD.0000000000004274
Wang Z, Wang Z, Li K, Su X, Du C, Tian Y. Radiofrequency thermocoagulation for the treatment of trigeminal neuralgia. Exp Ther Med. 2022;23(1):17.
pubmed: 34815769 doi: 10.3892/etm.2021.10939
Mertyna P, Dewhirst MW, Halpern E, Goldberg W, Goldberg SN. Radiofrequency ablation: the effect of distance and baseline temperature on thermal dose required for coagulation. Int J Hyperthermia. 2008;24(7):550–9.
pubmed: 18608586 doi: 10.1080/02656730802035662
Obrzut SL, Hecht P, Hayashi K, Fanton GS, Thabit G 3rd, Markel MD. The effect of radiofrequency energy on the length and temperature properties of the glenohumeral joint capsule. Arthroscopy. 1998;14(4):395–400.
pubmed: 9620651 doi: 10.1016/S0749-8063(98)70007-6
Shi W, Rudra R, Vu TN, Gordin Y, Smith R, Kunselman AR. Sensory stimulation threshold: a viable tool to improve the outcome of lumbar facet radiofrequency denervation? J Pain Res. 2021;14:2113–9.
pubmed: 34285571 pmcid: 8286126 doi: 10.2147/JPR.S319622
Eskandar E, Kumar H, Boini A, Velasquez Botero F, El Hunjul GN, Nieto Salazar MA, et al. The role of radiofrequency ablation in the treatment of trigeminal neuralgia: a narrative review. Cureus. 2023;15(3): e36193.
pubmed: 37065382 pmcid: 10104592
Headache Classification Subcommittee of the International Headache Society. The International Classification of Headache Disorders: 2nd edition. Cephalalgia. 2004;24(Suppl 1):9–160.
Tang YZ, Jin D, Li XY, Lai GH, Li N, Ni JX. Repeated CT-guided percutaneous radiofrequency thermocoagulation for recurrent trigeminal neuralgia. Eur Neurol. 2014;72(1–2):54–9.
pubmed: 24853911 doi: 10.1159/000357868
Li Y, Guo Y, Yang L, Ni J. Comparison of the short-term outcomes after low-temperature plasma radiofrequency ablation (coblation) in the Gasserian ganglion for the treatment of idiopathic trigeminal neuralgia. J Pain Res. 2019;12:1235–42.
pubmed: 31114305 pmcid: 6489685 doi: 10.2147/JPR.S199504
Harden RN, Weinland SR, Remble TA, Houle TT, Colio S, Steedman S, et al. Medication Quantification Scale Version III: update in medication classes and revised detriment weights by survey of American Pain Society Physicians. J Pain. 2005;6(6):364–71.
pubmed: 15943958 doi: 10.1016/j.jpain.2005.01.350
Jannetta PJ. Arterial compression of the trigeminal nerve at the pons in patients with trigeminal neuralgia. J Neurosurg. 1967;26(1):159–62.
doi: 10.3171/jns.1967.26.1part2.0159
Tew JM Jr, Keller JT. The treatment of trigeminal neuralgia by percutaneous radiofrequency technique. Clin Neurosurg. 1977;24:557–78.
pubmed: 583707 doi: 10.1093/neurosurgery/24.CN_suppl_1.557
Wang DD, Raygor KP, Cage TA, Ward MM, Westcott S, Barbaro NM, et al. Prospective comparison of long-term pain relief rates after first-time microvascular decompression and stereotactic radiosurgery for trigeminal neuralgia. J Neurosurg. 2018;128(1):68–77.
pubmed: 28298026 doi: 10.3171/2016.9.JNS16149
Barker FGN, Jannetta PJ, Bissonette DJ, Larkins MV, Jho HD. The long-term outcome of microvascular decompression for trigeminal neuralgia. N Engl J Med. 1996;334(17):1077–83.
pubmed: 8598865 doi: 10.1056/NEJM199604253341701
Elias WJ, Burchiel KJ. Microvascular decompression. Clin J Pain. 2002;18(1):35–41.
pubmed: 11803301 doi: 10.1097/00002508-200201000-00006
Resnick DK, Levy EI, Jannetta PJ. Microvascular decompression for pediatric onset trigeminal neuralgia. Neurosurgery. 1998;43(4):804–7.
pubmed: 9766307 doi: 10.1097/00006123-199810000-00047
Sweet WH, Wepsic JG. Controlled thermocoagulation of trigeminal ganglion and rootlets for differential destruction of pain fibers. 1. Trigeminal neuralgia. J Neurosurg. 1974;40(2):143–56.
pubmed: 4587949 doi: 10.3171/jns.1974.40.2.0143
Lopez BC, Hamlyn PJ, Zakrzewska JM. Systematic review of ablative neurosurgical techniques for the treatment of trigeminal neuralgia. Neurosurgery. 2004;54(4):973–82.
pubmed: 15046666 doi: 10.1227/01.NEU.0000114867.98896.F0
Teixeira MJ, Siqueira SR, Almeida GM. Percutaneous radiofrequency rhizotomy and neurovascular decompression of the trigeminal nerve for the treatment of facial pain. Arq Neuropsiquiatr. 2006;64(4):983–9.
pubmed: 17221008 doi: 10.1590/S0004-282X2006000600018
Koopman JS, de Vries LM, Dieleman JP, Huygen FJ, Stricker BH, Sturkenboom MC. A nationwide study of three invasive treatments for trigeminal neuralgia. Pain. 2011;152(3):507–13.
pubmed: 21239113 doi: 10.1016/j.pain.2010.10.049
Sterman-Neto H, Fukuda CY, Duarte KP, da Silva VA, Rodrigues ALL, Galhardoni R, et al. Balloon compression vs radiofrequency for primary trigeminal neuralgia: a randomized, controlled trial. Pain. 2021;162(3):919–29.
pubmed: 32947541 doi: 10.1097/j.pain.0000000000002070
Vinas FC, Zamorano L, Dujovny M, Zhao JZ, Hodgkinson D, Ho KL, et al. In vivo and in vitro study of the lesions produced with a computerized radiofrequency system. Stereotact Funct Neurosurg. 1992;58(1–4):121–33.
pubmed: 1439329 doi: 10.1159/000098985
Cheng JS, Lim DA, Chang EF, Barbaro NM. A review of percutaneous treatments for trigeminal neuralgia. Neurosurgery. 2014;10:25–33.
pubmed: 24509496
Zhao YX, Miao SH, Tang YZ, He LL, Yang LQ, Ma Y, et al. Trigeminal somatosensory-evoked potential: a neurophysiological tool to monitor the extent of lesion of ganglion radiofrequency thermocoagulation in idiopathic trigeminal neuralgia: a case-control study. Medicine (Baltimore). 2017;96(3): e5872.
pubmed: 28099345 doi: 10.1097/MD.0000000000005872

Auteurs

Aitao Wang (A)

Department of Pain Management, Huhhot First Hospital, Inner Mongolia, China.
Department of Pain Management, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Beijing, 100053, China.

Jingjing Bian (J)

Department of Pain Management, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Beijing, 100053, China.
Department of Anesthesiology, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.

Na Li (N)

Department of Pain Management, Huhhot First Hospital, Inner Mongolia, China.
Department of Pain Management, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Beijing, 100053, China.

Jiaxiang Ni (J)

Department of Pain Management, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Beijing, 100053, China.

Lea Zila (L)

Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.

Yuanzhang Tang (Y)

Department of Pain Management, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Beijing, 100053, China. medtangyz@hotmail.com.
Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA. medtangyz@hotmail.com.

Classifications MeSH