Temporal retrogasserian resection of trigeminal root versus controlled elective percutaneous electrocoagulation of the ganglion of gasser in the treatment of trigeminal neuralgia

In his experience with 531 surgical procedures for the relief of trigeminal neuralgia between 1955 to 1970, the author developed a strong preference for the percutaneous electro-coagulation of the gasserian ganglion. Although the method was repeatedly modified in the early years, a standardized technique of controlled, selective and fractional coagulation in the semiawake state of neurolept-anaesthesia was used since 1963 in 183 of his 311 patients, treated in this manner. The advantages of the method, particularly in comparison to open intracranial root sections, are: Minimal operative risk, control of operative effect during the operation, small sensibility deficit, low rate of complications, short hospitalization, short convalescence and satisfactory final result in 93% of the patients (after a second or third coagulation, if needed) in a three-year follow-up period.