Comparison of efficacy of adriamycin chemo-ganglionectomy and radiofrequency thermocoagulation of gasserian ganglionin in treating craniofacial postherpetic neuralgia

Abstract

Objective To compare the efficacy of adriamycin chemo-ganglionectomy and radiofrequency thermocoagulation (RFT) of semilunar ganglion in treating craniofacial postherpetic neuralgia (PHN). Methods A total of 95 patients with PHN in the areas innervated by maxillary and mandibular divisions of trigeminal nerve, aged 55-90 yr, with the course of disease 6 months-3 yr, were divided into 2 groups using a random number table method: adriamycin chemo-ganglionectomy group (ADM group, n=48) and RFT group (n=47). Hartel anterior approach to puncture was performed via the foramen ovale under the guidance of CT in two groups.In group ADM, 0.5% adriamycin 2.5 mg (0.5 ml) was injected via the foramen ovale, and RFT of gasserian ganglion was performed in group RFT.Visual Analog Scale (VAS) and the short-form McGill pain questionnaire (SF-MPQ) scores were evaluated before and after treatment.The rate of effective treatment was calculated, and treatment-related complications were recorded. Results Compared with group RFT, no significant change was found in VAS or SF-MPQ scores before treatment, VAS and SF-MPQ scores were increased and the rate of effective treatment was decreased at 1 and 7 days after treatment, VAS and SF-MPQ scores were decreased and the rate of effective treatment was increased at 6 and 12 months after treatment, the incidence of facial numbness, hypoesthesia, masticatory muscle weakness and weakened corneal reflex was decreased in group ADM (P<0.05). Conclusion Compared with semilunar ganglion RFT, the long-term efficacy of adriamycin chemo-ganglionectomy of semilunar ganglion in treating craniofacial PHN is enhanced, and the safety is higher. Key words: Neuralgia, postherpetic; Doxorubicin; Electrocoagulation; Trigeminal ganglion