[Neurosurgical therapy of XXXX ].

@entity1 @entity5 @entity4254 @entity5663 @entity31465 @entity51 @entity5587 @entity86 @entity158 @entity10 @entity282 @entity15 @entity9 @entity130
INTRODUCTION: @entity9 of the face, especially @entity4254 and @entity5587 are indications for surgical interventions after failed medical therapy. In contrast to other forms of @entity10 or atypical @entity158 , where surgical measures are considered to be contraindicated, percutaneous procedures or @entity5663 are able to produce immediate and @entity158 relief. Careful preoperative evaluation is essential to confirm the clinical diagnosis and to rule out other causes as @entity15 or @entity5 afflicting the cranial nerves. The following study will summarize the common surgical techniques and their role considering a mechanism-based therapy as well as document long-term results of these measures. METHODS: Between 1977 and 1997 316 thermo-controlled radiofrequency trigeminal rhizotomies (TK) and 379 @entity5663 ( @entity5663 ) were performed in our hospital to treat @entity4254 ; additional 6 MVDs for @entity5587 and one @entity5663 of the intermediate facial nerve were carried out. Questionnaires were sent out to all @entity1 still living in 1981, 1982, 1992 and 1998. For all other @entity1 , interviews with relatives or the general practitioners were conducted. A retrospective analysis of @entity282 relief was performed using Kaplan-Meier curves at the latest follow-up. Additionally 80 @entity1 underwent careful quantitative sensory testing with Von-Frey-hairs. RESULTS: 225 @entity1 who underwent @entity5663 and 206 with radiofrequency trigeminal rhizotomies were further analyzed. There was a 50% risk for @entity158 recurrence two years after radiofrequency rhizotomy. On the other hand 64% of @entity1 who underwent @entity5663 remained painfree 20 years postoperatively. @entity1 with @entity5663 without @entity51 were painfree significantly longer than @entity1 with @entity86 . DISCUSSION: Etiology and pathogenesis of @entity31465 are far from understood despite several hypotheses. Based on current models there is no explanation for the immediate @entity158 relief especially after @entity5663 . Some authors even discuss surgical @entity130 as the only cause for @entity282 relief.
