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Abstract:

Background: Conventional percutaneous thermocoagulation of postgasserian fibers has shown high success rates, with significant residual morbidity. Methods: This communication summarizes conclusions of multiple publications on our computerized mapping method and technique, and presents new data on short- and long-term results on trigeminal pain, including an actuarial analysis, complications. Results: In TTN, 97.4% of 75 procedures produced initial pain relief without medication. In all, 84.7% of appropriate verbal responses were achieved by proper location of the needle at the chosen target, requiring an average of 1.45 tracts per procedure. Needle tip was located between 1 and 15 mm below the sellar floor in 97.0% of procedures and in an angle of 40° to 80° regarding the clivus profile projection in 99.1%. A 93% reduction of corneal analgesia and a 100% suppression of major dysesthesias and cranial nerve palsies were found. Conclusion: We have shown a significant reduction of morbidity from percutaneous thermocoagulation of postgasserian fibers with similar short- and long-term results as those shown in 11 recently selected series. Strict adherence to all details of our new method and technique is essential. Future multiinstitutional studies are needed to confirm and enrich this small series. © 2009 Elsevier Inc. All rights reserved.

Registro:

Documento: Artículo
Título:A multiarray mapping method to minimize morbidity from thermocoagulation as treatment of refractory trigeminal neuralgia
Autor:Karol, E.A.; Karol, B.; Perez, A.; Cueto, G.
Filiación:Department of Neurosurgery, Buenos Aires University, 1428 Buenos Aires, Argentina
Palabras clave:Functional neurosurgery; Pain; Thermocoagulation; Thermorhyzotomy; Trigeminal neuralgia; tricyclic antidepressant agent; adult; aged; analgesia; article; computer program; controlled study; cranial nerve paralysis; disease duration; dysesthesia; facial nerve paralysis; female; hematoma; herpes simplex; human; major clinical study; male; morbidity; needle; refractory period; thermocoagulation; trigeminus neuralgia; Adult; Aged; Aged, 80 and over; Brain Mapping; Computers; Electric Stimulation; Electrocoagulation; Electrodiagnosis; Female; Fluoroscopy; Humans; Male; Microelectrodes; Middle Aged; Monitoring, Intraoperative; Neuronavigation; Neurosurgical Procedures; Postoperative Complications; Transcutaneous Electric Nerve Stimulation; Treatment Outcome; Trigeminal Ganglion; Trigeminal Neuralgia
Año:2009
Volumen:71
Número:4
Página de inicio:411
Página de fin:418
DOI: http://dx.doi.org/10.1016/j.surneu.2008.11.011
Título revista:Surgical Neurology
Título revista abreviado:Surg. Neurol.
ISSN:00903019
CODEN:SGNRA
Registro:https://bibliotecadigital.exactas.uba.ar/collection/paper/document/paper_00903019_v71_n4_p411_Karol

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Citas:

---------- APA ----------
Karol, E.A., Karol, B., Perez, A. & Cueto, G. (2009) . A multiarray mapping method to minimize morbidity from thermocoagulation as treatment of refractory trigeminal neuralgia. Surgical Neurology, 71(4), 411-418.
http://dx.doi.org/10.1016/j.surneu.2008.11.011
---------- CHICAGO ----------
Karol, E.A., Karol, B., Perez, A., Cueto, G. "A multiarray mapping method to minimize morbidity from thermocoagulation as treatment of refractory trigeminal neuralgia" . Surgical Neurology 71, no. 4 (2009) : 411-418.
http://dx.doi.org/10.1016/j.surneu.2008.11.011
---------- MLA ----------
Karol, E.A., Karol, B., Perez, A., Cueto, G. "A multiarray mapping method to minimize morbidity from thermocoagulation as treatment of refractory trigeminal neuralgia" . Surgical Neurology, vol. 71, no. 4, 2009, pp. 411-418.
http://dx.doi.org/10.1016/j.surneu.2008.11.011
---------- VANCOUVER ----------
Karol, E.A., Karol, B., Perez, A., Cueto, G. A multiarray mapping method to minimize morbidity from thermocoagulation as treatment of refractory trigeminal neuralgia. Surg. Neurol. 2009;71(4):411-418.
http://dx.doi.org/10.1016/j.surneu.2008.11.011