Surgeries

We perform

Surgeries:

Trigeminal radiofrequency rhizotomy

Trigeminal Neuralgia is a rare type of facial pain characterised by severe, intermittent, sharp, shooting, electric shock pain which is triggerable by eating, drinking, touch, wind. There is no prior history of injury, shingles or surgery which may cause other types of facial pain.  It typically responds to drugs like Tegretol or Carbamazepine and is unlikely to respond to typical pain relieving medications.

There are two general surgical treatments for trigeminal neuralgia which is refractory to medical therapy. The first, microvascular decompression or MVD is discussed previously and involves a craniotomy. The second type involve less invasive treatments to numb the nerve and these can usually be performed as an outpatient surgery.

Trigeminal radiofrequency rhizotomy is a minimally invasive procedure to provide relief of trigeminal neuralgia pain. It involves numbing branches of the trigeminal nerve using radiofrequency or electricity to selectively block the pain carrying fibres. Correctly performed it is successful in 95% of patients and can provide long duration of pain relief. It is ideal for patients with multiple sclerosis trigeminal neuralgia, those not fit for cranial surgery or after pain recurrence with other treatment modalities.

Before surgery a CT and x ray are performed to assist with navigation. The procedure is performed under sedation or general anaesthesia. Once asleep a poke incision is made in the cheek and the radiofrequency needle is advanced into the foramen ovale. Stimulation can then be elicited to get the exact localisation of the probe to treat the exact location of pain. Once confirmed a radiofrequency lesion is made under sedation. The aim is to create an area of discrete mild numbness to block the pain.

Risks of the procedure are excessive facial numbness, incomplete pain relief and rarely stroke or death. Depending on the depth of numbness pain relief can be short to long lasting but the procedure can be repeatedly as required.

Trigeminal radiofrequency rhizotomy

Trigeminal Neuralgia is a rare type of facial pain characterised by severe, intermittent, sharp, shooting, electric shock pain which is triggerable by eating, drinking, touch, wind. There is no prior history of injury, shingles or surgery which may cause other types of facial pain.  It typically responds to drugs like Tegretol or Carbamazepine and is unlikely to respond to typical pain relieving medications.

There are two general surgical treatments for trigeminal neuralgia which is refractory to medical therapy. The first, microvascular decompression or MVD is discussed previously and involves a craniotomy. The second type involve less invasive treatments to numb the nerve and these can usually be performed as an outpatient surgery.

Trigeminal radiofrequency rhizotomy is a minimally invasive procedure to provide relief of trigeminal neuralgia pain. It involves numbing branches of the trigeminal nerve using radiofrequency or electricity to selectively block the pain carrying fibres. Correctly performed it is successful in 95% of patients and can provide long duration of pain relief. It is ideal for patients with multiple sclerosis trigeminal neuralgia, those not fit for cranial surgery or after pain recurrence with other treatment modalities.

Before surgery a CT and x ray are performed to assist with navigation. The procedure is performed under sedation or general anaesthesia. Once asleep a poke incision is made in the cheek and the radiofrequency needle is advanced into the foramen ovale. Stimulation can then be elicited to get the exact localisation of the probe to treat the exact location of pain. Once confirmed a radiofrequency lesion is made under sedation. The aim is to create an area of discrete mild numbness to block the pain.

Risks of the procedure are excessive facial numbness, incomplete pain relief and rarely stroke or death. Depending on the depth of numbness pain relief can be short to long lasting but the procedure can be repeatedly as required.