Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 6, 2019; 7(9): 1060-1065
Published online May 6, 2019. doi: 10.12998/wjcc.v7.i9.1060
Nerve coblation for treatment of trigeminal neuralgia: A case report
Xiao-Hui Yang, Yan Li, Li-Qiang Yang, Bai-Shan Wu, Jia-Xiang Ni
Xiao-Hui Yang, Yan Li, Li-Qiang Yang, Bai-Shan Wu, Jia-Xiang Ni, Department of Pain Medicine, Capital Medical University Xuanwu Hospital, Beijing 100053, China
Xiao-Hui Yang, Department of Pain Medicine, Aerospace Central Hospital, Beijing 100049, China
Yan Li, Li-Qiang Yang, Bai-Shan Wu, Jia-Xiang Ni, National Clinical Research Center for Geriatric Disorders, Beijing 100053, China
Informed consent statement: The patient involved in this study gave written informed consent authorizing the use and disclosure of his protected health information.
Conflict-of-interest statement: The authors of this manuscript have no conflicts of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Jia-Xiang Ni, MD, Professor, Department of Pain Medicine, Capital Medical University Xuanwu Hospital, No. 45, Changchun Street, Xicheng District, Beijing 100053, China. jiaxiang_ni@126.com
Telephone: +86-10-83198160 Fax: +86-21-57643271
Received: January 9, 2019
Peer-review started: January 10, 2019
First decision: January 26, 2019
Revised: February 21, 2019
Accepted: March 16, 2019
Article in press: March 16, 2019
Published online: May 6, 2019
Processing time: 117 Days and 2.7 Hours
Abstract
BACKGROUND

Trigeminal neuralgia (TN) is a severe type of neuropathic pain which is often inadequately managed using conventional therapies. In this report, we present the first case of TN treated with gasserian ganglion nerve coblation (NC).

CASE SUMMARY

A 58-year-old man presented with right facial pain, mostly localized in the right zygomatic zone, alveolar region, and jaws. Similar to acupuncture and shock pain, the pain lasted about five seconds after each attack before resolving unaided. A diagnosis of TN was made, after which treatment with acupuncture therapy and oral carbamazepine was given. However, the pain was not satisfactorily controlled. Subsequently, gasserian ganglion NC of the right trigeminal nerve guided by computed tomography (CT) was performed on the patient. Following this procedure, the right zygomatic, alveolar, submandibular, and cheek pain disappeared completely. The right zygomatic and alveolar areas experienced mild numbness (level II). At 1-, 2-, 3-, and 6-mo follow-ups after surgery, the patient was painless and the numbness score was level I.

CONCLUSION

CT-guided gasserian ganglion (NC) is an effective treatment for TN and is associated with less or no postoperative numbness or hypoesthesia in comparison with current standard-of-care approaches.

Keywords: Nerve coblation; Trigeminal neuralgia; Gasserian ganglion; Computed tomography guided; Case report

Core tip: Pain due to diseases or injuries affecting the trigeminal nerve can be devastating. Conventional drug-based therapies are often ineffective in controlling advanced trigeminal neuralgia (TN). On the other hand, surgical interventions, although showing better success than most drugs, are at times accompanied by numbness and relapsing pain. In this case, we report the treatment of a patient who presented with signs of TN using an innovative technique, computed tomography (CT)-guided nerve coblation (NC). The patient reported neither feeling pain nor numbness when followed for up to a period of six months. CT-NC, therefore, is a minimally invasive technique for the treatment of TN bearing the advantages of inducing little trauma and being effective in alleviating pain without causing postoperative numbness.