日本語AIでPubMedを検索
V2+V3特発性三叉神経痛の治療には、半月状神経節ラジオ波熱凝固術と比較して、ロータンドゥム孔、卵巣孔を介した末梢神経ラジオ波熱凝固術を用いた
The treatment of V2 + V3 idiopathic trigeminal neuralgia using peripheral nerve radiofrequency thermocoagulation via the foramen rotundum and foramen ovale compared with semilunar ganglion radiofrequency thermocoagulation.
PMID: 32590251 DOI: 10.1016/j.clineuro.2020.106025.
抄録
目的:
V2+V3特発性三叉神経痛患者のための新たで利用可能な手術法を探るために、ロータンダム孔（FR）と卵巣孔（FO）を介した末梢神経高周波（RF）熱凝固術（PRF）と局所麻酔下での半月状神経節RF熱凝固術（GRF）との長所と短所を比較すること。
OBJECTIVES: To compare the advantages and disadvantages of V2 + V3 idiopathic trigeminal neuralgia using peripheral nerve radiofrequency (RF) thermocoagulation (PRF) via the foramen rotundum (FR) and foramen ovale (FO) with those of semilunar ganglion RF thermocoagulation (GRF) under local anesthesia, for exploring a new and available surgical method for patients with V2 + V3 idiopathic trigeminal neuralgia.
患者と方法:
本プロスペクティブ無作為化比較臨床試験では、V2+V3特発性三叉神経痛患者102名を登録し、PRF群とGRF群に無作為に分けた（両群ともn=51）。疼痛緩和のアウトカムは、Barrow Neurological Institute（BNI）の疼痛スコアを用いて評価し、良好（BNIクラスIまたはII、投薬不要）と不良（BNIクラスIII-V、投薬が必要または失敗）に分類した。再発とは、より高いレベルの疼痛緩和を達成した後、以前の低レベルへの再発と定義した。即効率、術後2年の有効率、術後2年の再発率、合併症の数を観察し、記録した。
PATIENTS AND METHODS: 102 patients with V2 + V3 idiopathic trigeminal neuralgia were enrolled in this prospective randomized controlled clinical trial, and they were divided into the PRF and GRF group randomly (n = 51 in both groups). The outcome of pain relief was assessed using the Barrow Neurological Institute (BNI) pain score, and grouped as good (BNI Class I or II, no medication required) and bad (BNI Class III-V, medication required or failed). Recurrence was defined as a relapse to a previous lower level after attainment of any higher level of pain relief. The immediate effective rate, the 2-year postoperative effective rate, the 2-year postoperative recurrence rate, and the number of complications were observed and recorded.
結果:
両者の基本条件（年齢、男女比、疼痛側、罹患期間）は類似していた。さらに、両群間の術後2年有効率には有意差がないことがわかった。両群を比較すると、PRF群はV2枝の即効率が高く、角膜潰瘍などの重篤な合併症もなかったが、GRF群はV3枝の術後2年再発率が低く、顔面腫脹も少なかった。
RESULTS: Their basic conditions (age, gender ratio, side of pain, and disease duration) were similar. Furthermore, we found that the 2-year postoperative effective rate between them had no significant difference. By comparing the two groups, PRF group had the better immediate effective rate of the V2 branch and no severe complications such as corneal ulcer, however, GRF group had lower 2-year postoperative recurrence rate of the V3 branch and fewer facial swelling.
結論:
PRF手術もGRFと同様に、即効性に優れ、位置が正確で安全性が高いことから、V2+V3特発性三叉神経痛に対する前向きな治療法の一つである。
CONCLUSION: The PRF surgery, like GRF, is another prospective treatment for V2 + V3 idiopathic trigeminal neuralgia by virtue of its excellent immediate effect, accurate positioning and high safety.
Copyright © 2020 Elsevier B.V. All rights reserved.