Predictive Factors in Maxillary and Mandibular Nerve Radiofrequency Treatment for Trigeminal Neuralgia
Condition: Trigeminal Neuralgia
MeSH terms: Trigeminal Neuralgia; Neuralgia
Study type: Observational

Summary: 
      Trigeminal neuralgia is one of the most common craniofacial neuralgias and one of the most
      severe types of facial pain, typically limited to the distribution of the trigeminal nerve.
      The first-line treatment for trigeminal neuralgia is medical therapy and primarily
      antiepileptic drugs. Various interventional and surgical methods can be used in patients who
      do not respond to medical treatment or who cannot tolerate side effects. Pulsed
      radiofrequency treatment of maxillary and mandibular nerves may provide longer-lasting pain
      relief in trigeminal neuralgia.This study aimed to investigate the clinical and demographic
      characteristics affecting treatment success in patients who underwent ultrasound-guided
      pulsed radiofrequency of the maxillary and/or mandibular nerves for trigeminal neuralgia.
    

Detailed description: 
      Pulsed radiofrequency treatment applied to the maxillary and mandibular nerves, which are the
      peripheral branches of the trigeminal nerve, is frequently used in patients with trigeminal
      neuralgia who do not adequately respond to medical treatment.

      Pain intensity was evaluated at baseline and 3 months after US-guided maxillary and/or
      mandibular nerve PRF treatment using NRS (numerical rating scale). The primary outcome
      measure was percent reduction in pain, with 50% pain relief lasting at least 3 months was
      defined as a positive categorical outcome.

      In addition, demographic data such as age (years), gender, duration of pain (months),
      etiology (idiopathic or secondary), MRI findings (normal findings or abnormal findings due to
      conditions such as vascular compression and demyelinating plaque), pain side (unilateral or
      bilateral), and history of Gasser ganglion RF ablation were obtained from patient data. NRS
      scores before and 3 months after PRF were collected from the patient data and recorded.
      Pre-procedural cranial MRI and MR cisternography reports were accessed from patient records,
      and any abnormalities were recorded. We retrospectively analyzed the patient's electronic
      medical history records and the archive system containing the imaging results to obtain the
      variables.

      The main aim of this study was to determine the clinical and demographic variables associated
      with treatment outcomes in patients with TN who underwent PRF of the maxillary and mandibular
      nerves. The secondary aim of this study was to determine the incidence of procedure-related
      adverse events.
    

Intervention name(s): Maxillary nerve and mandibular nerve pulsed radiofrequency
Intervention type(s): Procedure
Intervention description(s): For maxillary nerve pulsed radiofrequency, the lineer transducer is placed distal and parallel to the zygomatic arch, bridging the coronoid and condylar processes and a 22 gauge 6 mm RF cannula was inserted into the target area. With sensory stimulation, patients experienced a distinct sensation in upper jaw, teeth, and palate. Then, PRF treatment was performed at 42 °C for 240 seconds.
For mandibular nerve pulsed radiofrequency, the transducer was placed distally and parallel to the zygomatic arch, bridging the coronoid and condylar processes. The pterygopalatine fossa was visualized and the needle was inserted to target area. With sensory stimulation, patients experienced a distinct sensation in the lower jaw and teeth. With motor stimulation, a throwing movement of the jaw was observed with contraction of the masseter and temporal muscles. PRF treatment was performed at 42 °C for 240 s.
Observational model: Other
Time perspective: Retrospective
Sampling method: Non-Probability Sample
Study population: 
        Male and female patients who underwent maxillary and/or mandibular nerve pulsed
        radiofrequency for trigeminal neuralgia
      
Keywords: mandibular nerve; maxillary nerve; pulsed radiofrequency; ultrasound; analgesia