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Percutaneous Procedures for Trigeminal Neuralgia

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Diagnosis and Management of Head and Face Pain

Abstract

Trigeminal neuralgia (TN) refractory to medical management may be treated by percutaneous rhizotomy via radiofrequency, glycerol, or balloon compression. These procedures are minimally invasive with a high rate of pain relief with low procedural risk and are preferred to microvascular decompression in patients with advanced age, medical comorbidities, symptomatic TN from multiple sclerosis, and failure of other surgical treatments. An understanding of the anatomic relationship of the foramen ovale to its surrounding structures is essential for safe insertion of the needle, and the treatment selectivity of the trigeminal nerve distribution differs based on the procedure chosen. Rates of acute pain relief are excellent, although some degree of hypesthesia is usually seen and symptoms frequently recur in the years after treatment, which can make repeat procedures necessary. This chapter will address patient selection, perioperative considerations, surgical techniques, complications, and outcome after percutaneous procedures for TN.

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Author information

Authors and Affiliations

  1. Department of Neurological Surgery, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA

    Michael D. Staudt & Jonathan P. Miller

  2. Case Western Reserve University, School of Medicine, Cleveland, OH, USA

    Maricruz Rivera

Authors
  1. Michael D. Staudt
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  2. Maricruz Rivera
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  3. Jonathan P. Miller
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Correspondence to Jonathan P. Miller .

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Editors and Affiliations

  1. Department of Otolaryngology-HNS, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA

    James Y. Suen

  2. Department of Neurosurgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA

    Erika Petersen

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Staudt, M.D., Rivera, M., Miller, J.P. (2018). Percutaneous Procedures for Trigeminal Neuralgia. In: Suen, J., Petersen, E. (eds) Diagnosis and Management of Head and Face Pain. Springer, Cham. https://doi.org/10.1007/978-3-319-90999-8_18

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  • DOI: https://doi.org/10.1007/978-3-319-90999-8_18

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