CC BY-NC-ND 4.0 · Asian J Neurosurg 2024; 19(02): 221-227
DOI: 10.1055/s-0044-1779516
Research Article

Microvascular Decompression versus Radiofrequency Ablation in Trigeminal Neuralgia of the Maxillary and Mandibular Divisions

1   Neurosurgery Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt
Mohamed Hamdy Ellakany
2   Anesthesia and Pain Management Department, Medical Research Institute, Alexandria University, Alexandria, Egypt
Hossam Elnoamany
1   Neurosurgery Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt
Ahmed Gabry Elnaggar
1   Neurosurgery Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt
› Author Affiliations
Funding None.


Background Although medical treatment is the mainstay of therapy, in trigeminal neuralgia (TN), patients failing to respond to it make them candidates to ablative or nonablative procedures.

Objective The aim of this study was to compare the outcome of Microvascular decompression (MVD) and radiofrequency (RF) thermocoagulation in the management of TN affecting the mandibular and maxillary divisions.

Materials and Methods Retrospective analysis of the data of 40 patients suffering from intractable classical TN affecting the maxillary or mandibular divisions or both was carried out. Twenty patients were operated upon by MVD of the trigeminal nerve; and 20 had RF ablation of the maxillary or mandibular divisions of the trigeminal nerve or both.

Results In MVD the overall successful outcome was achieved in 16 patients (80%), while the failure was in 4 patients (20%) of which 3 had a fair outcome and 1 patient had a poor outcome. Whereas in RF the overall successful outcome was achieved in 17 patients (85%), while the failure was in 3 patients (15%) of which 2 had a fair outcome and 1 patient had a poor outcome. Outcome was insignificantly different between both groups (p-value 0.806).

Conclusion MVD and RF ablation represent safe and efficacious surgical choices for addressing TN that encompasses both the mandibular and maxillary divisions. Long-term follow-up studies demonstrate that MVD consistently yields favorable outcomes, establishing it as the preferred primary surgical technique, unless contraindicated by the patient's general health and specific needs.

Ethical Approval

The study was approved by the Local Ethical Scientific Committee of the Menoufia Faculty of Medicine, Menoufia, Egypt. The Institutional Review Board (IRB) approval number and date ID: 4/2023NEUS14-2.

Authors' Contributions

All authors contributed equally.

Publication History

Article published online:
27 May 2024

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