背景:三叉神经带状疱疹,其中包括10%至20%的带状疱疹病例,常导致眼部分支剧烈疼痛。目前的治疗方法,包括药物治疗和微创干预,有局限性;因此,有必要探索替代方法。这项研究旨在评估难治性三叉神经疱疹性疼痛患者的计算机断层扫描(CT)引导的蝶腭神经节脉冲射频的疗效和安全性。
方法:对3例顽固性三叉神经痛患者进行研究。所有患者都抱怨头痛发作,每天至少发生10次,通常在眶周和额叶区域。常规治疗,包括针对三叉神经-半月神经节和眶上神经的口服药物和射频治疗,不能提供足够的救济。
方法:2例诊断为三叉神经眼支带状疱疹伴结膜炎,而一名患者被诊断为三叉神经眼支带状疱疹后神经痛。
方法:本研究采用了一种新的方法,该方法涉及CT引导下的翼腭窝蝶腭神经节的射频调节。
结果:在所有三名患者中,治疗后1~3天内疼痛缓解.在后续行动中,一名患者疼痛复发;然而,其严重程度比治疗前疼痛严重程度约低40%.第二名患者持续有效地缓解疼痛。然而,第三个患者的疼痛在2个月后再次恶化。平均随访3个月。所有入选患者均未出现治疗相关不良反应或并发症。
结论:我们的研究结果表明,CT引导下射频调节翼腭窝蝶腭神经节是治疗三叉神经痛患者疼痛的一种安全有效的干预措施,这表明如果其他治疗失败,它可能是一种治疗选择。
BACKGROUND: Trigeminal herpes zoster, which comprises 10% to 20% of cases of herpes zoster, often leads to severe pain in the ophthalmic branches. Current treatments, including drug therapy and minimally invasive interventions, have limitations; accordingly, there is a need to explore alternative approaches. This study aimed to evaluate the efficacy and safety of computerized tomography (CT)-guided pulsed radiofrequency of the sphenopalatine ganglion in patients with intractable trigeminal herpetic pain.
METHODS: Three patients with intractable trigeminal ophthalmic zoster neuralgia were studied. All patients complained of bursts of headache, which occurred at least 10 times a day, usually in the periorbital and frontal regions. Conventional treatments, including oral medications and radiofrequency therapy targeting the trigeminal-semilunar ganglion and supraorbital nerve, could not sufficiently provide relief.
METHODS: Two patients were diagnosed with herpes zoster in the ocular branch of the trigeminal nerve with conjunctivitis, while one patient was diagnosed with postherpetic neuralgia in the ocular branch of the trigeminal nerve.
METHODS: This study employed a novel approach that involved CT-guided radiofrequency regulation of the pterygopalatine fossa sphenopalatine ganglion.
RESULTS: In all three patients, pain relief was achieved within 1 to 3 days after treatment. During the follow-up, one patient had pain recurrence; however, its severity was ≈ 40% lower than the pretreatment pain severity. The second patient had sustained and effective pain relief. However, the pain of the third patient worsened again after 2 months. The average follow-up duration was 3 months. None of the enrolled patients showed treatment-related adverse reactions or complications.
CONCLUSIONS: Our findings indicated that CT-guided radiofrequency regulation of the pterygopalatine fossa sphenopalatine ganglion was a safe and effective intervention for pain in patients with trigeminal ophthalmic zoster neuralgia, suggesting that it may be a therapeutic option if other treatments fail.