Stereotactic Radiofrequency Gasserian Ganglionotomy

Shin, Keun Man; Shin, Sam Chyul; Cho, Yong Roew; Lim, So Young; Hong, Soon Yong; Choi, Young Ryong

Abstract

When medical therapy fail to relieve pain at tolerable level for patients confirmed with trigeminal neuralgia, presence of mass lesion excluded, surgery is indicated. Innumerable surgical strategies have been attempted for the treatment of trigeminal neuralgia but only four have proven appropriate: (1) stereotactic radiofrequency gasserian ganglionotomy, (2) percutaneous glycerol gangliolysis, (3) percutaneous microcompression, (4) microvascular decompression. Radiofrequency thermocoagulation of the gasserian ganglion stems from the efforts of Sweet. This technique is the surgical treatment of choice around the world for surgical treatment for trigeminal neuralgia. Since 1986, over 14,000 cases have been reported utilizing this technique. To improve the treatment method further, an electrode with a flexible curved tip has been developed for easier and more precise electrode placement and lesion produetion during the thermocoagulation of gasserian ganglion. This operation was performed recently on three patients at Hallym University Hospital, using a curved tip electrode. Complete relief of pain was achieved for all patient. However, some complications were noted.