Percutaneous trigeminal thermorhizotomy in treatment of malignant facial pain

Management of Skull Base Tumor-Associated Facial Pain

Cancer-associated facial pain can be caused by a variety of pathologic conditions. Here the authors describe the symptoms and incidence of facial pain secondary to three separate anatomic subcategories of cancer. The authors subsequently discuss the effectiveness and drawbacks of the most common methods of treatment.

Percutaneous surgical treatment of trigeminal neuralgia

The authors report on indications and results of percutaneous surgical treatment of trigeminal neuralgia based on own experiences in 1124 cases. In 912 cases percutaneous thermorhizotomy and in 212 cases percutaneous microcompression have been used. As a conclusion the following considerations have been stressed: I) In both methods slight hypaesthesia appears to obtain good pain relief; II) Percutaneous thermorhizotomy is indicated in third division neuralgias; III) Percutaneous microcompression is indicated for first and second division neuralgias only when the trigeminal cistern is not abnormally dilated; IV) Undesirable side-effects after either thermorhizotomy and microcompression are similar and transitory in most cases; V) Pain recurrence for both procedures are comparable and range at about 25%.

Combined thermocoagulation of the 5th and 9th cranial nerves for oral pain of neoplastic aetiology

The authors report their limited but interesting experience in the treatment of intractable oral pain employing the technique of percutaneous radiofrequency thermocoagulation both of the trigeminal and glossopharyngeal nerves. The use of combined percutaneous thermolesions for cancer pain is rarely described in the literature. Immediate and long-term results confirm the usefulness of this surgical procedure.