CT定位选择性射频热凝术治疗原发性三叉神经痛

目的探讨CT定位选择性三叉神经半月节射频热凝术治疗原发性三叉神经痛的临床价值。方法选择24例原发性三叉神经痛，Hartel前入路穿刺法，局麻CT定位下经卵圆孔穿刺三叉神经半月节，经电生理验证后温控射频热凝对靶点进行选择性毁损治疗。结果疼痛消失18例，疼痛减轻5例，无缓解1例，总有效率95、8％（23／24）。24例随访3～18个月，平均12个月。2例（8、3％）复发。结论CT定位选择性三叉神经半月节射频热凝术治疗原发性三叉神经痛安全简便，疗效可靠，并发症少，尤其适用于高龄或不能耐受开颅手术的病人。

CT-guided selective radiofrequency thermocoagulation for the treatment of primary trigeminal neuralgia

Objective To explore the clinical value of CT-guided selective radiofrequency thermocoagulation of the semilunar ganglion for the treatment of primary trigeminal neuralgia(PTN).Methods A total of 24 patients with PTN were included.Under local anesthesia and CT guidance,the semilunar ganglion was punctured by way of the oval foramen via the anterior approach using the Hartel's technique.Selective radiofrequency thermocoagulation was performed after the targets were confirmed by electrical stimulation. Results The pain was completely relieved in 18 patients,partially relieved in 5 patients,and unchanged in 1 patient,the total effective rate being 95.8%(23/24).Follow-up observations for 3~18 months(mean,12 months) in the 24 patients showed recurrence in 2 patients(8.3%).Conclusions CT-guided selective radiofrequency thermocoagulation is a safe,simple,and effective option for the treatment of PTN,especially suitable for the elderly and high-risk patients.