Radiofrequency thermocoagulation combined with pulsed radiofrequency for gasserian ganglion blockage

Tülin Arıcı1, Mustafa Kurcaloglu1, Ertuğrul Kilic2, Elvan Erhan1

1Department of Anaesthesiology, Reanimation and pain, Ege University Faculty of Medicine, İzmir, Turkey
2Department of Anaesthesiology, Reanimation and Pain, Dr. Ersin Arslan Research and Training Hospital, Gaziantep, Turkey

Keywords: Gasserian ganglion blockage, pulsed radiofrequency; radiofrequency thermocoagulation; trigeminal neuralgia.

Abstract

Objectives: Trigeminal neuralgia (TN) has been effectively treated by radiofrequency thermocoagulation (RFT) of the gasserian ganglion. Recently, pulsed radiofrequency (PRF) is becoming an alternative therapy for patients with trigeminal neuralgia. It is unclear whether the combination of RFT with PRF may decrease post-operative complications while maintaining long-term pain relief.
Methods: Twelve patients with idiopathic TN who had undergone combined RFT and PRF of the gasserian ganglion were evaluated. PRF (42 °C, 45V, 20 ms, 120 seconds) was administered, and then RFT (65 °C, 90 seconds) was performed to the gasserian ganglion. The post-operative pain relief and complications were evaluated at 1, 6, 12 and, 24 months after treatment.
Results: 10 patients (83.3%) reported significant pain relief (VAS 3) at 1 month following the treatment, while 8 patients (66.6%) at 6 months, 5 patients (41.6) at 12 months, and 2 patients (16.6%) at 24 months were pain-free. Two of the patients did not have pain relief (VAS ≥3), and 2 patients were still pain-free by the 24th month. The mean time of pain relief was 14 months. One patient had numbness in the tongue for about a year, while in the other patients, no serious complications were reported.
Conclusion: A combination of RFT with PRF could help eliminate postoperative complications of trigeminal neuralgia. We sugesst that combining RFT and PRF therapy may serve to decrease the side effects but not increase the pain relief.