Minimally invasive trigeminal ablation in patients with refractory trigeminal neuralgia who are ineligible for intracranial intervention

Yasser Tajali, Max Ward, Mickey Abraham, Machteld Hillen, Omar Mahmoud, Yehuda Herschman, Antonios Mammis, Boris Paskhover

Research output: Contribution to journalArticle

Abstract

We describe the use of minimally invasive trigeminal ablation, an endoscopic ablative technique to treat trigeminal neuralgia in patients who are traditionally poor surgical candidates. We present 4 patients who presented with refractory unilateral trigeminal neuralgia. Three of the patients had previously failed stereotactic radiosurgery and three of them have multiple sclerosis. Due either to lack of neurovascular compression, minimally invasive trigeminal ablation was offered. Intraoperatively, an incision is made along the buccal mucosa or mid-brow and the tissue is endoscopically dissected in a plane towards the symptomatic nerve. Once isolated, the epineurium is partially ablated with thermocautery and the tissue surrounding the nerve is decompressed. All patients reported resolution of their pain post-operatively and were pain free at last follow up. Two patients had mild hypesthesia over the ablated nerve territory. Minimally invasive trigeminal ablation is a safe and effective technique for symptomatic control of trigeminal neuralgia. The efficacy, low risk, and relative ease of the procedure makes it ideal for use in patients who are refractory to medical management and have no neurovascular compression, are unable to tolerate traditional surgery or have failed other therapies.

Original languageEnglish (US)
Pages (from-to)42-46
Number of pages5
JournalJournal of Clinical Neuroscience
Volume70
DOIs
StatePublished - Dec 2019

Fingerprint

Trigeminal Neuralgia
Nerve Tissue
Hypesthesia
Radiosurgery
Mouth Mucosa
Peripheral Nerves
Multiple Sclerosis
Pain

All Science Journal Classification (ASJC) codes

  • Surgery
  • Neurology
  • Clinical Neurology
  • Physiology (medical)

Keywords

  • Comorbidity
  • Gamma knife
  • MITA
  • Minimally invasive trigeminal ablation
  • Multiple sclerosis
  • Radiosurgery
  • Trigeminal neuralgia

Cite this

Tajali, Yasser ; Ward, Max ; Abraham, Mickey ; Hillen, Machteld ; Mahmoud, Omar ; Herschman, Yehuda ; Mammis, Antonios ; Paskhover, Boris. / Minimally invasive trigeminal ablation in patients with refractory trigeminal neuralgia who are ineligible for intracranial intervention. In: Journal of Clinical Neuroscience. 2019 ; Vol. 70. pp. 42-46.
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Minimally invasive trigeminal ablation in patients with refractory trigeminal neuralgia who are ineligible for intracranial intervention. / Tajali, Yasser; Ward, Max; Abraham, Mickey; Hillen, Machteld; Mahmoud, Omar; Herschman, Yehuda; Mammis, Antonios; Paskhover, Boris.

In: Journal of Clinical Neuroscience, Vol. 70, 12.2019, p. 42-46.

Research output: Contribution to journalArticle

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