三叉神经节射频治疗中感官刺激和副作用之间的关系

三叉神经节射频治疗中感官刺激和副作用之间的关系。

Relationship between Sensory Stimulation and Side Effects in Percutaneous Radiofrequency Treatment of the Trigeminal Ganglion (pages 581–587)

Mark V. Koning, Nick J. Koning, Henk M. Koning and Maarten van Kleef

摘要

目的：本研究的目的是为了确定三叉神经节射频消融治疗三叉神经痛患者的疗效，并确认这种治疗是长期有效的，同时评估射频治疗的参数。

方法：通过以下问。对28名患者进行回顾性研究，并整合。

结果：可以观察到89%的病人在初始治疗后是有效的，60%的病人在12个月随访中持续有效。主要的副作用是感觉减退（56%），眼干（20%）和咬肌无力（12%）。治疗期间结合轻度的感官刺激会获得更好的满意度，促进疼痛缓解，但感觉减退的趋势更明显。

讨论：这个小样本的研究报道了老年人群中的治疗效果和先前的研究相类似。在长期的随访中发现，只有感觉减退的发生率较高。这个研究表明，射频消融治疗三叉神经痛是高度有效的，但存在一个很大的副作用。更引人注目的是，轻度的感官刺激与感觉减退的增加有关，而高度的感官刺激几乎没有效果。进一步研究经皮射频消融三叉神经节的感官刺激度是有必要的。

Abstract

Introduction

The objective of this study was to determine the efficacy of percutaneous radiofrequency (RF) treatment of the trigeminal ganglion for treating patients with trigeminal neuralgia, to determine which patients have a long-term benefit, and to evaluate the effect of RF parameters.

Methods

A retrospective study in 28 consecutive patients in combination with a follow-up questionnaire (n=26, 93% response).

Results

An initial treatment effect of 89% was observed, 60% sustained at 12-month follow-up. Major side effects were hypesthesia (56%), dry eye (20%), and masseter muscle weakness (12%). A lower sensory stimulation threshold during treatment was associated with better patient satisfaction (P=0.016), improved pain relief (P=0.039), and trended toward more hypesthesia (P=0.077).

Discussion

This low-volume study reported treatment effects in an older population that were similar to previous studies. Only a higher incidence of hypesthesia was detected by long-term follow-up. This study supported the high efficiency of RF treatment, but there was a high level of side effects. Most notable, low sensory stimulation was associated with increased hypesthesia, whereas higher stimulation levels yielded less effectiveness. Further investigation of an optimal sensory stimulation range for percutaneous RF treatment of the trigeminal ganglion was found to be warranted.