Clinical Observation Of Semicircular Ganglion Radiofrequency Thermocoagulation And Foramen Ovale Combined With Foramen Rotundum Peripheral Nerve Radiofrequency Thermocoagulation For Treatment Of(?+?) Idiopathic Trigeminal Neuralgia

Objective:A randomized controlled study was conducted to compare the efficacy and complications of CT guided radiofrequency thermocoagulation of semilunar ganglion via foramen ovale approach and selective radiofrequency thermocoagulation of peripheral nerve via foramen ovale combined with foramen rotundum in the treatment of(?+?)idiopathic trigeminal neuralgia.Method:This study is a randomized controlled clinical trial.70 patients with(?+?)idiopathic trigeminal neuralgia diagnosed in the First Affiliated Hospital of Nanchang University from January 2015 to December 2016 were randomly divided into two groups: CT guided radiofrequency thermocoagulation of semilunar ganglion via foramen ovale approach under local anesthesia(GRF)and CT guided selective radiofrequency thermocoagulation of peripheral nerve via foramen ovale combined with foramen rotundum under local anesthesia(SRF).Visual analogue score(VAS)was used to evaluate the pain on the first day after operation.The pain assessment table of Barrow Neurological Institute(BNI)was used to evaluate the postoperative efficacy,and the effective rate and related complications after operation were observed.After 2 years of follow-up,Kaplan-Meier survival curve was used to show the 2 years postoperative efficacy,and the recurrence rate was observed 2 years after operation.Result:(1)There were no statistical differences in preoperative general conditions between the two groups.(2)The VAS score of group GRF was higher than that of SRF on the first day after operation,and the difference was significant.(3)The total effective rates of GRF and SRF were 77.14% and 97.14% respectively on the first day after operation,and the difference was significant.(4)On the first day after operation,the effective rates of GRF group ?,GRF group ?,SRF group ? and SRF group ? were 77.14%,100.00%,100.00% and 97.14%,respectively.There weresignificant differences among the four groups.The effective rate of GRF group ? were significantly different from GRF group ?,SRF group ? and SRF group ?.(5)There was no significant difference in survival curve between GRF and SRF.(6)The survival curves of GRF group ? were significantly different from SRF? and SRF?.(7)The total recurrence rates of GRF and SRF in 2 years after operation were 25.92%and 57.57%,respectively.The difference was statistically significant.(8)The 2-year recurrence rates of GRF ?,GRF ?,SRF ? and SRF ? were 14.81%,18.51%,39.39%,48.48%,respectively.There was significant difference among the four groups.There were significant differences between GRF ? and SRF ?,GRF ? and SRF ?,GRF ? and SRF ?.(9)The incidence of facial swelling in SRF group was higher than that of GRF,with statistical significance;the incidence of sensory numbness in branch ? was lower in SRF than that in GRF,with statistical significance.Conclusions:The immediate postoperative efficacy of radiofrequency thermocoagulation via foramen ovale semilunar ganglion(GRF)for(?+?)idiopathic trigeminal neuralgia was lower than that of selective radiofrequency thermocoagulation via foramen ovale combined with foramen rotundum(SRF),but the recurrence rate within 2 years was lower than SRF,and the incidence of complications of SRF is lower than GRF.Foramen ovale combined with foramen rotundum selective peripheral nerve radiofrequency thermocoagulation(SRF)is an effective surgical treatment for(?+?)idiopathic trigeminal neuralgia,because of its accurate positioning,high selectivity and high safety.