CT-guided trigeminal ganglion neurolysis combined with sphenopalatine ganglion neurolysis for persistent idiopathic facial pain: A retrospective comparative analysis with propensity score matching

Abstract

Background: Persistent idiopathic facial pain (PIFP) is one of the most challenging diseases to management. This retrospective comparative analysis is to compare the outcome of trigeminal ganglion (TG) neurolysis combined with sphenopalatine ganglion (SPG) neurolysis versus SPG neurolysis. The neurolysis was performed under CT guidance with oxygen-ozone gas. Methods: A retrospective clinical study was performed of retrospectively acquired data between January 2008 and January 2020 at our Pain Management Center. Patients were allocated into two groups; Group A: SPG neurolysis; Group B: TG neurolysis combined with SPG neurolysis. The baseline prognostic factors were equalized between the two groups using propensity score matching (PSM). Results: A total of 84 patients were enrolled in the two groups. Based on pain assessment by visual analogue scale (VAS), there was significant reduction for Group B versus Group A by one week that persisted till 1 year. The treatment success rate in Group A was 85.2% (29 of 34), 64.7% (22 of 34), 52.9% (18 of 34), 58.8% (20 of 34) and 47.1% (16 of 34) at 1 day, 1 week, 3 months, 6 months and 1 year after surgery, respectively. And in Group B was 94.1% (32 of 34), 82.4% (28 of 34), 70.6% (24 of 34), 76.5% (26 of 34), and 70.6% (24 of 34) respectively. No serious complications or side effects were observed. Conclusions: CT-guided TG neurolysis combined with SPG neurolysis has a relatively better reduction of pain score than SPG neurolysis only.