经皮穿刺圆孔射频治疗上颌神经痛的临床研究

目的:探讨经皮穿剌圆孔射频治疗上颌神经痛的疗效。方法:对21例内科治疗失败或有创治疗后复发的上颌神经痛患者,在X线引导下,将头端塑形的普通射频穿刺针,以前下方入路经皮经翼腭窝穿刺圆孔,对上颌神经干行射频温控热凝处理。以视觉模拟评分法(visual analoguescale,VAS)记录患者术前、术后72小时以及术后随访期内疼痛程度来评价治疗疗效。结果:对21患者成功施行23次上颌神经干射频热凝术。21例患者术前VAS评分7.4±1.6分。术后72小时所有患者VAS评分均为0分。手术后随访时间4周到9周(平均31周),未出现上颌神经痛复发。术后上颌神经分布区面部麻木感发生率95.2%(20/21),面部肿胀发生率38.1%(8/21),无角膜感觉神经功能损伤病例发生。结论:经皮穿刺圆孔射频温控热凝处理上颌神经干治疗三叉神经上颌支痛是安全和有效的。

THE CLINICAL EFFICACY OF RADIOFREQUENCY THERAPY THROUGH FORAMEN ROTUNDUM ON MAXILLARY NEURALGIA

Objective: To investigate the clinical efficacy of radiofrequency therapy through foramen rotundum on maxillary neuralgia.Methods: 21 paitents with maxillary neuralgia who had failed to respond to medical treatments or relapsed after surgical treatment were enrolled in this study.Fine-needle was punctured foramen rotundum through pterygopalatine fossa under fluoroscopic guidance.The needle tip segment was shaped into 40 degree arc.Radiofrequecy ablation of maxillary nerve stem was carried out in 21 patients.Visual analogue scale(VAS) was used to evaluate the therapeutic efficacy.VAS score was determined before and 72 hours after the treatment.Result: The procedure was successfully accomplished in 21 patients for 23 times.Pain was completely relieved immediately after the operation.VAS score was 7.4 ± 1.6 before the operations.The VAS score decreased to 0 at 72 hours after the operations.The time of follow-up lasted from 4 weeks to 49 weeks(mean of 31 weeks).No recurrent pain occurred.The incidence of numbness in maxillary nerve distribution was 95.2%(20/21).The incidence of facial swelling was 38.1%(8/21).No ophthalmic nervous lesion was seen.Conclusion: Radiofrequency ablation of maxillary nerve stem through foramen rotundum is an effective and safe treatment for maxillary neuralgia.