[The results of trigeminal nucleotractotomy in facial pain]

In 1987 to 1997, open ultrasonic vertical trigeminal nucleotractotomy was performed in 46 patients with drug-resistant facial pain syndromes. There were 29 patients with deafferentation pain, 14 with migraine-induced neuralgia and 3 with trigeminal neuralgia due to multiple sclerosis. The operation included unilateral suboccipital craniotomy, C1 hemilaminectomy and vertical destruction of the trigeminal nucleus and descending tract with an ultrasonic microsurgical needle. The rostral limit of trigeminal nucleotractotomy depended on the site of facial pain. In the early postoperative period, there were good (relief of baseline pain or mild pain requiring no medical therapy) in 44 (96%) patients and poor results in 2 (4%). Late results of follow-ups lasting 1 to 11 years (mean 6.1 years) were known in 39 patients. Good, fair (pain control with medication), and bad results were preserved in 25 (64%), 4 (10%), and 10 (26%) patients. Trigeminal nucleotractotomy is effective in relieving intractable facial pain.