Clinical value of adriamycin injection via foramen ovale and around peripheral trigeminal branches under guidance of X-ray for treatment of primary trigeminal neuralgia: a comparison with three-dimensional CT

Objective To evaluate the clinical value of adriamycin injection via the foramen ovale and around peripheral trigeminal branches under the guidance of X-ray for treatment of primary trigeminal neuralgia by comparison with the three-dimensional computed tomography(CT). Methods A total of 91 patients with primary trigeminal neuralgia of both sexes, aged 33-76 yr, with the course of disease 6 months-24 yr, with visual analogue scale score of 6-9, were divided into 2 groups using a random number table: X-ray group(n=43)and CT group(n=48). Hartel anterior approach was used to puncture the foramen ovale in 2 groups.One point five percent adriamycin 0.2, 0.3 and 0.5 ml were injected via the supraorbital foramen, infraorbital foramen and oval foramen.When pain relief was poor(visual analogue scale score≥ 4)within 1 yr after treatment, oxcarbazepine and adjuncts(tramadol, flupentixol and melitracen tablets, etc.)were taken orally.The requirement for oxcarbazepine and adjuncts was recorded during 1 day-1 week, 1 week-1 month, 1-3 months, 3-6 months and 6 months-1 yr after treatment periods.The operation time, the number of puncture, and development and recurrence of complications during treatment and within 1 yr after treatment were recorded. Results Compared with CT group, the number of puncture and incidence of facial hematoma during treatment were significantly increased(P 0.05). Conclusion Compared with the three dimensional CT, X-ray provides similar efficacy and safety when used to guide adriamycin injection via the foramen ovale and around peripheral trigeminal branches for treatment of primary trigeminal neuralgia, showing that X-ray guidance has significant clinical value. Key words: Tomography, X-ray computed; Imaging, three-dimensional; Adriamycin; Trigeminal neuralgia