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

Objectives: To evaluate the results of carbon dioxide (CO₂) laser as an alternative treatment of trigeminal neuralgia.

Methods: 10 patients (2 males, 8 females, mean age = 62.50±17.01 years) with refractory trigeminal neuralgia underwent the peripheral nerve ablation by CO₂ laser using low power with defocused mode. Pain intensity was determined by numerical rating scales (NRS) and daily drug use was evaluated before operation, 1, 4 and 8 weeks after operation. Paired-samples t-test was used to determined statistical significance.

Results: There was a significant difference in pain level and daily drug use between preoperative and postoperative 1, 4, and 8 weeks (NRS = 9.4±0.84, 2.90±2.51, 0.90±1.20, and 0.60±1.08 respectively, daily drug use = 720.00±297.40, 380.00±234.76, 220.00±239.44, and 130.00±163.64 respectively; p<0.05). Nine patients had some degree of paresthesia of the effected nerves, while one patient had no sensory alteration but the painful symptom was relieved.

Conclusions: CO₂ laser can be used as an alternative treatment for patients with trigeminal neuralgia who do not respond medical treatment or cannot tolerate side effects of medication. The only complication was paresthesia. However, further study with a larger group of patients is recommended to evaluate the outcome of this treatment for the long-term period.