Percutaneous methods for the treatment of trigeminal neuralgia and other faciocephalic pain; comparison with microvascular decompression.

The treatment of trigeminal neuralgia by the minor percutaneous invasive procedures of selective thermal rhizotomy, glycerol injection, and balloon compression in the middle cranial fossa are compared with the open operations of compression in the middle fossa and MVD in the posterior fossa. A conservative end point for any one of the three percutaneous methods is recommended as the first invasive procedure in this disorder. The management of the facial pains in multiple sclerosis, cancer, posttraumatic and postherpetic pain, migrainous neuralgia (cluster headache), and vagoglossopharyngeal neuralgia is also discussed.