Percutaneous Retrogasserian Glycerol Rhizolysis in the Management of Trigeminal Neuralgia

삼차 신경통 치료로서 경피적 후가세르 글리세롤 신경근파괴술

Percutaneous retrogasserian glycerol rhizolysis(PRGR) was performed in 43 patients, a total of 65 times, for the management of typical trigeminal neuralgia from 1987 to 1991. The age of patients was distributed between 19 and 87 years. According to sex 17 were male and 26 were female. Pure glycerol of 0.3-0.8 ml was injected into the Meckel's cave on the affected site. In 31 PRGR(Group I) that had cisternography to titrate the dose of glycerol, when treated, 26 G of these PRGR patients(83.9%) had relief of pain. There were recurrence of pain in 7PRGR (22.6%) and the average interval from the PRGR to recurrence of pain in 7 PRGR(22.6%) and the average interval from the PRGR to recurrence of pain was 16.9 months. In 34 PRGR(Group II) of which bupivacaine was injected to titrate the dose of glycerol, 29 PRGR(85.3%) had relief of pain 80 howing treatment. There were recurrence of pain in 8 PRGR(23.5%) and the average interval from the PRGR to the recurrence of pain was 14.3 months. Finally of all procedures done(65 PRGR), 55 PRGR(84.6%) had relief of pain. There were recurrence of pain in 15 PRGR(23.1%) and the average interval from the PRGR to recurrence of pain was 15.5 months. There was no significant difference between the two groups in the rate of pain relief. There were conjunctival irritation(3 cases), headache(2), vomiting(3), hematoma(2), and herpes simplex(3) as transient complications after PRGR. Corneal ulceration and anesthesia dolorosa did not develop in any cases.