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Authors Li Y, Guo Y, Yang L, Ni J
Received 29 December 2018
Accepted for publication 15 March 2019
Published 17 April 2019 Volume 2019:12 Pages 1235—1242
DOI https://doi.org/10.2147/JPR.S199504
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Cristina Weinberg
Peer reviewer comments 2
Editor who approved publication: Dr Michael Ueberall
Background: Low-temperature
plasma radiofrequency ablation (coblation) is a relatively novel technique with
promising applications in neuropathic pain. A nerve stimulator was modified and
connected to a plasma knife head to solve the problem of accessing the
Gasserian ganglion for treatment of trigeminal neuralgia (TN).
Objective: To
compare the therapeutic effects and short-term outcomes of coblation vs radiofrequency
thermocoagulation for the treatment of primary TN.
Methods: This was
a retrospective cohort study of 217 inpatients who had undergone surgical
treatment for primary TN between September 2017 and June 2018 at the Xuanwu
Hospital, Capital Medical University. The patients were grouped according to
the procedure they selected after an informed comprehensive discussion with
their surgeon: the coblation group and the radiofrequency group. Pain,
numbness, and muscle atrophy were evaluated before surgery, on the day of
surgery, and at 3 days, 5 days, and 3 months after surgery.
Results: In the
coblation and radiofrequency groups, the pain relief rates were 74.7% and 85.5%
on day 1 (P =0.066),
85.3% and 97.3% on day 3 (P =0.003), and 97.7% and 88.2% at 3 months (P =0.134). At 3
months after surgery, 69.3% of the patients in the coblation group and 42.7% in
the radiofrequency group had no pain (P <0.001). The multivariable analysis showed that
the risk of numbness in the coblation group was independently lower than in the
radiofrequency group at 3 months after surgery and (OR=0.243, 95%CI:
0.122–0.484, P <0.001). Three months after the surgery, no
recurrence was found in both of the coblation group and the radiofrequency
group. Postoperative pain score ≥4 points was considered as a sign of failure
this series at 3 months after surgery. The failure rate in coblation group is
2.7% (n=2) and a radiofrequency group is 4.5% (n=5), but there was no
statistical difference between the two groups (P =0.703).
Conclusion: Coblation
could reduce the risk of postoperative numbness in patients with primary TN.
Keywords: trigeminal
neuralgia, low-temperature plasma radiofrequency ablation (coblation),
radiofrequency thermocoagulation, Gasserian ganglion