Glycerol Rhizolysis for Trigeminal Neuralgia
A plethora of percutaneous procedures are available for the management of trigeminal neuralgia (TGN). Percutaneous procedures are useful in patients with drug-refractory TGN, who either refuse surgery, or in those with significant medical risks to undergo invasive surgical procedures. Percutaneous retrogasserian glycerol rhizolysis (PRGR) is one of the most popular methods of treatment for TGN. PRGR is carried out by injecting glycerol into the Meckel’s cave and its safety has been established by several studies [1–4]. The major advantages of PRGR are: (1) long-term pain relief following single injection, (2) significant reduction in postoperative facial deafferentation compared to thermal rhizotomy, and (3) simple to perform with an image intensifier. Precise anatomic placement of anhydrous glycerol is achieved with the help of intraoperative trigeminal water-soluble contrast cisternography prior to drug injection [5–8].
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