| Abstract [eng] |
Introduction. Trigeminal neuralgia (TN) is widely recognized as one of the most debilitating forms of craniofacial pain, characterized by severe, sudden, brief, and recurrent unilateral episodes of stabbing pain within the distribution of the trigeminal nerve. The objective of this study was to assess the clinical outcomes of radiofrequency destruction of the trigeminal ganglion and to provide an overview of other interventional treatment modalities. Subjects and methods. A retrospective analysis was conducted on outpatient and inpatient records of patients diagnosed with TN at VUL SK from 2018 to 2023. Data collected included patient demographics, referring specialists and interventions performed. Data were analysed using descriptive statistical methods. In addition, a case series analysis was performed on seven patients treated between 2017 and 2024 at the Pain Medicine Centre of VUL SK. Collected data included age, sex, comorbidities, clinical presentation, duration of symptoms, prior medical and interventional therapies, and pain intensity before and after RD. Results. Between 2018 and 2023, a total of 811 patients with TN were seen in the outpatient setting at VUL SK, with the highest number recorded in 2022 (20.6%). The majority were female (73.6%), with a mean age of 57.9 years (SD ±16.2). Anaesthesiologists were the most frequent specialists consulted (36.5%), while emergency medicine physicians accounted for the fewest referrals (5.8%). During the same period, 89 TN patients were treated in the inpatient setting, with the highest number of hospitalizations observed in 2023 (36%). Hospitalized patients were predominantly female (70.8%), with a mean age of 62.6 years (SD ±16.1). The most commonly performed procedures were radiofrequency gangliotomy (44.9%) and gangliotomy with balloon compression (40.4%), whereas percutaneous neurotomy was performed in only 2.2% of cases. The case series included seven patients (four females and three males) aged 47 to 72 years, with TN durations ranging from 5 to 17 years. Five patients were diagnosed with classical TN, and two with TN secondary to multiple sclerosis. Patients described severe, electric shock-like facial pain rated 8–10 on the SAS scale, often triggered by eating, speaking, or facial stimulation, most frequently affecting the V2–V3 divisions of the trigeminal nerve. Prior to RA, all patients underwent PNI; additionally, six patients received PRF, four underwent MVD, three underwent PBC, and one patient each underwent GKRS and BTI. Three months following RD, all patients experienced a significant reduction in pain intensity, with no complications reported. Conclusions. This study confirms that patients treated for TN at VUL SK between 2018 and 2023 were predominantly older females. RD of the trigeminal ganglion proved to be an effective and safe intervention for patients with drug resistant TN to pharmacological and other interventional treatments. |
