Carbon-dioxide Laser in the Treatment of Trigeminal Neuralgia: A Preliminary Study

Objective: This study was performed to evaluate the results of carbon dioxide laser in the treatment of trigeminal neuralgia (TN). Methods: Thirty six patients (11 men, 25 women) with refractory TN underwent peripheral nerve ablation with CO2 laser using low power defocused mode. Pain intensity was determined by numerical rating scales at preoperation, 1 week, 1 month, 3 months, 6 months, and 12 months post-operation. One way ANOVA was used to determine statistical significance. Results: There were significant differences in pain between pre-operation and 1 week, 1 month, 3 months, 6 months, and 12 months post-operation (pain score=9.38 ± 0.91, 3.15 ± 3.24, 1.00 ± 1.41, 0.63 ± 1.18, 0.75 ± 1.16 and 1.63 ± 1.99 respectively; p<0.05). Thirty four patients had some degree of prolonged paresthesia of the effected nerves, while two patients had no sensory alteration but the pain was relieved. Conclusions: Neural ablation with CO2 laser can be an alternative treatment for patients with TN who do not respond to the medical treatment or cannot tolerate the side effects of medication or do not want to have intracranial surgery. The only complication was prolonged paresthesia of the effected nerve. However, further study with a larger group of patients and longer observation period are recommended to evaluate the outcome of this treatment.