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Related Experiment Video

Updated: Jul 2, 2026

Subcutaneous Trigeminal Nerve Field Stimulation for Refractory Facial Pain
09:35

Subcutaneous Trigeminal Nerve Field Stimulation for Refractory Facial Pain

Published on: May 10, 2017

Computed tomography-guided percutaneous trigeminal tractotomy-nucleotomy.

Yucel Kanpolat1, Gokmen Kahilogullari, Hasan C Ugur

  • 1Department of Neurosurgery, School of Medicine, Ankara University, Sihhiye, Turkey. kanpolat@ada.net.tr

Neurosurgery
|September 9, 2008
PubMed
Summary

Computed tomography-guided trigeminal tractotomy and/or nucleotomy (TR-NC) effectively treats various intractable facial pain syndromes. This minimally invasive procedure offers high efficacy and a low complication rate for conditions like atypical facial pain and cancer pain.

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Area of Science:

  • Neurosurgery
  • Pain Management
  • Radiology

Background:

  • Trigeminal tractotomy (TR) and trigeminal nucleotomy (NC) are procedures targeting the trigeminal nerve pathways for pain relief.
  • These interventions are applicable to a range of debilitating facial pain conditions, including neuralgias and cancer-related pain.

Purpose of the Study:

  • To evaluate the efficacy and safety of computed tomography-guided trigeminal tractotomy and/or nucleotomy (TR-NC).
  • To analyze the outcomes of TR-NC in patients with diverse intractable facial pain syndromes over a 20-year period.

Main Methods:

  • A retrospective analysis of 65 patients undergoing computed tomography-guided TR-NC.
  • Pre- and postoperative pain scores and Karnofsky Performance Scale scores were assessed.

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Last Updated: Jul 2, 2026

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Main Results:

  • Successful pain relief was achieved in most patients across various conditions, including atypical facial pain (19/21), vagoglossopharyngeal neuralgia (17/17), geniculate neuralgia (4/4), and craniofacial cancer pain (11/13).
  • Four of five patients with previously failed trigeminal neuralgia also experienced effective pain management with TR-NC.

Conclusions:

  • Computed tomography-guided TR-NC provides direct visualization, enhancing procedural accuracy.
  • The procedure is proposed as a first-line treatment due to its high efficacy, minimal invasiveness, and low complication rates for intractable facial pain.