Glycerol rhizotomy via a retrosigmoid approach as an alternative treatment for trigeminal neuralgia

C. Rory Goodwin, Jesse X. Yang, Chetan Bettegowda, Brian Hwang, Carol James, Ann Biser, Shaan Raza, Matthew Bender, Benjamin Carson, John Y.K. Lee, Michael Lim

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives Trigeminal neuralgia is a sensory nerve disorder characterized by lancinating pain and treated most commonly with carbamazepine, rhizotomy treatment, or open surgical management with microvascular decompression. We describe a novel technique to complement surgical treatment for trigeminal neuralgia via direct injection of the trigeminal nerve with glycerin in the cisternal portion of the nerve. Patients and methods We performed a retrospective analysis of patients who received standard microvascular decompression and injection of glycerin to the inferior third of the cisternal portion of the nerve anterior to the root entry zone with lack of a compressive vessel on MRI as the primary indication. Fourteen patients were identified and demographic information, post-operative course and complications were recorded. Results There were eleven females and three males with an average age at time of surgery of 54.8 years. 100% of patients reported that their trigeminal pain was significantly improved following surgical intervention. Four out of fourteen patients reported a 50-80% decrease from the pre-surgery baseline pain at one month and three month follow up. One patient developed a CSF leak, and no surgical site infections or motor deficits were observed. Conclusion Intra-operative glycerin rhizotomy in conjunction with microvascular decompression can be used to safely treat patients suffering from trigeminal neuralgia.

Original languageEnglish (US)
Pages (from-to)2454-2456
Number of pages3
JournalClinical Neurology and Neurosurgery
Volume115
Issue number12
DOIs
StatePublished - Dec 2013

Keywords

  • Glycerin rhizotomy
  • Retrosigmoid
  • Tic douloureux
  • Trigeminal neuralgia

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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