Outcome of Radiofrequancy Ablation of Gasserian Ganglion for the Management of Trigeminal Neuralgia: Prospective Interventional Study

Background: Trigeminal neuralgia (TN) is characterized by sudden, severe, lancinating pain confined to one or more divisions of the trigeminal nerve. This study aimed to evaluate the efficacy and safety of radiofrequency ablation (RFA) targeting the Gasserian ganglion and identify factors influencing post-procedural outcomes. Methods: A prospective interventional study was conducted on patients diagnosed with TN and admitted to the Neurosurgery Department at Benha University Hospitals between February 2024 and October 2024. All patients underwent clinical evaluation preoperatively and postoperatively, along with brain MRI to exclude secondary causes. Pain severity was assessed using the Visual Analog Scale (VAS). Results: Twelve patients (6 males, 6 females) with a mean age of 57 years were included. The mean preoperative VAS score was 9.75, indicating severe pain. Following RFA, pain scores significantly decreased to a mean of 0.33, demonstrating marked improvement. Recurrence occurred in a small subset of patients, with moderate pain levels (mean VAS ≈ 5), but overall pain relief was highly significant. Minor complications were reported in 5 patients: three cases of facial ecchymosis at the needle insertion site and two cases of postoperative facial paresthesia. No major adverse events were observed. Conclusions: RFA of the Gasserian ganglion is a highly effective and safe intervention for TN, providing substantial pain relief, rapid recovery, and minimal complications. These findings support RFA as a preferred minimally invasive technique for managing medically refractory TN, with low recurrence and favorable safety profiles.