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Percutaneous radiofrequency trigeminal rhizotomy for brain tumor-related secondary trigeminal neuralgia
Author(s): ,
C.-W. Liao
Affiliations:
Chiayi Chang Gung Memorial Hospital, Puzi, Taiwan
,
W.-C. Huang
Affiliations:
Chiayi Chang Gung Memorial Hospital, Puzi, Taiwan
,
P.-J. Tsai
Affiliations:
Chiayi Chang Gung Memorial Hospital, Puzi, Taiwan
,
Y.-J. Kuo
Affiliations:
Chiayi Chang Gung Memorial Hospital, Puzi, Taiwan
,
W.-Y. Cheng
Affiliations:
Chiayi Chang Gung Memorial Hospital, Puzi, Taiwan
,
C.-H. Kao
Affiliations:
Chiayi Chang Gung Memorial Hospital, Puzi, Taiwan
,
C.-C. Yang
Affiliations:
Chiayi Chang Gung Memorial Hospital, Puzi, Taiwan
J.-T. Yang
Affiliations:
Chiayi Chang Gung Memorial Hospital, Puzi, Taiwan
EANS Academy. Liao C. Oct 21, 2018; 225763; EP7029
Chien-Wei Liao
Chien-Wei Liao
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Abstract
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Background:
Trigeminal neuralgia (TN) is caused infrequently by brain tumors with an incidence of about 5-10%. The surgical removal of the tumor is the most effective for pain relief, but is not suitable for the high surgical risk patients. In this retrospective study, we evaluated the efficacy of percutaneous radiofrequency trigemial rhizotomy (RF-TR) for treating trigemial pain in those patients.

Methods:
From to Dec. 2010 to March. 2016, a total of 391 patients with TN were included in our study. 20 patients, having brain tumor but refusing surgical excision of the lesion, underwent RF-TR. The use of intraoperative CT (iCT), MRI and integrated neuronavigation technology in our previous series successfully decreased the procedure time and perioperative morbidities. A satisfaction survey was performed with a phone interview. The numerical rating scale (NRS) was used to evaluate the severity of pain before and after the procedure.

Results:
The result shows that the primary tumor sites were at cerebello-pontine angle (11), petrous-clivus (6), posterior fossa (2), and Merkel's cave (1). The average NRS score was 9.68±0.61 before the procedure and 0.86±1.60 post treatment ( 8.82 in NRS decrease) in at least 2 years follow-up. The postoperative complications included masseter weakness (n=1), diplopia (n=1), and painful dysesthesia (n=8).

Conclusion:
RF-TR is a simple, safe and minimally invasive procedure that shows immediate and prolonged reduction of TN secondary to brain tumors.
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