This is the treatment of choice when the patient is elderly or medically unfit for a major cranial procedure.
This procedure is done with you sedated. A thin needle is passed into the skin of the cheek on the side of your face where the pain is, after cleaning with a sterilising agent. Using x-ray or a surgical navigation computer, the needle is then passed through the check, next to the mouth, and guided through the opening in the base of the skull to where all three branches of the trigeminal nerve come together. The Trigeminal nerve is then numbed by either using heat generated by an electric current or by an injection of Glycerol. When glycerol is injected, you are made to lean forward at the end of the procedure, with your head tilted downwards and will have to maintain that uncomfortable position for 2 hours.
This procedure is usually a day procedure and you are discharge by evening.
Risks of the procedure
Common risks include:
- Failure to adequately relieve the pain.
- Bleeding. Bleeding is more common if you have been taking blood thinning drugs such as Warfarin, Aspirin, Clopidogrel (Plavix or Iscover) or Dipyridamole (Persantin or Asasantin).
Uncommon risks include:
- Cranial nerve damage. This may result in loss of hearing, facial weakness & numbness, double vision, hoarse voice, difficulty swallowing &/or impaired tongue movements.
- Hydrocephalus. This may be temporary or permanent and may require a second operation.
- Brain fluid leakage can occur after the operation. This may require further surgery.
- Infection inside the brain. This will require further treatment.
- Weakness of chewing muscles on the effected side of your face. This is usually temporary.
- Heart attack. A heart attack because of the strain on the heart or a stroke.
- Clots in the leg (deep vein thrombosis or DVT) with pain and swelling. Rarely part of this clot may break off and go into the lungs.
- Small areas of the lung may collapse, increasing the risk of chest infection. This may need antibiotics and physiotherapy.
- Increase risk in obese people of wound infection, chest infection, heart and lung complications, and thrombosis.
Rare risks include:
- Bleeding inside the head or brain. This would require further surgery.
- Meningitis. This would require further treatment.
- Death is rare due to this procedure.