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These procedures work by deliberately injuring the trigeminal nerve in order to stop pain signals going to the brain. With the patient under general anaesthetic, the surgeon inserts a needle through the cheek into the base of the trigeminal nerve, where the nerve divides into its three main branches. The surgeon may then use:
Radiofrequency Lesioning to heat the nerve branch so that pain is no longer triggered.
Glycerol Injection to chemically destroy the offending nerve branch.
Balloon Compression to compress and therefore damage the nerve by inserting and inflating a tiny balloon.
Advantages
These procedures are less invasive than MVDs and usually only require a few hours’ stay in hospital. They give pain relief for around 5 years, nearly always work with classical TN and can be repeated.
Disadvantages
These procedures cause varying degrees of numbness in the face, which is impossible to predict. Complications can be permanent and distressing.
For those who are too old or unwell to undergo these surgeries, similar procedures may be used to stop the pain by finding the nerve trigger point and cutting it (neurectomy), freezing it (cryotherapy) or injecting it with alcohol. These minor procedures are performed under local anaesthetic and can offer up to a year’s pain relief.
