Some experience of trigeminal neuralgia treatment by glycerol rhizolysis
Aim. The study was to evaluate the advantages and disadvantages of trigeminal neuralgia treatment by Hakanson S. glycerol rhizolysis method. Methods. The results of glycerol rhizolysis treatment were retrospectively evaluated in 96 patients with trigeminal neuralgia, who had been operated at Neurosurgical Department of Irkutsk City Hospital over a period from 2009 to 2016. To study the prospective follow-up, 53 patients operated during 2009 -2014 were surveyed over the phone. The comparison of our long-term results and the results of other authors from literature sources was then performed. Results. The median of follow-up period was 43 months. The pain recurrence (III-V rate of Barrow Neurological Institute score for trigeminal neuralgia) was observed in 30.2 % of patients, with the mean rate of the visual analogue scale amounting to 1.96. Complications included aseptic meningitis in 3.1 % cases, intracerebral hematoma - 1.04 %, hyperesthesia in appropriate trigeminal region - 3.8%, labial herpes - 40.7 %, temporary anesthesia in appropriate trigeminal region - 30.2%, temporary decrease of corneal reflex sensitivity - 41.5 %. There was no postoperative mortality. Conclusion. Glycerol rhizolysis is an effective method of trigeminal neuralgia treatment and its results are comparable with those of other surgical methods. Strict adherence to all surgical steps and contrast cistenography is the key to success of intervention. The method is minimally invasive, applicable for anesthesia and particularly promising for patients over 70 years old.