Research Progress on Radiofrequency Treatment of Primary Trigeminal Neuralgia in the V2 Maxillary Nerve

Primary trigeminal neuralgia (TN) involving the V2 maxillary nerve presents unique therapeutic challenges. Traditional radiofrequency techniques at the semilunar ganglion often lack selectivity and carry risks of injuring adjacent nerves. The recently refined CT-guided foramen ovale puncture radiofrequency thermocoagulation technique has significantly improved outcomes for V2 TN. This narrative review systematically explores the evolution of radiofrequency treatment for V2 TN, with a particular focus on comparing the efficacy and safety of different puncture pathways. We emphasize the superior clinical utility of the infrazygomatic approach, which offers greater precision and fewer complications than the obsolete orbital and mandibular routes. Furthermore, we discuss the impact of technical innovations, such as personalized needle modification, on treatment precision. This review aims to consolidate current evidence and provide practical, evidence-based guidance for clinicians managing this complex pain condition.