What is Trigeminal Nerve Radiofrequency Thermocoagulation

  Radiofrequency thermocoagulation is the use of high temperatures on the ganglia, nerve trunks and nerve roots to coagulate and denature their proteins, thereby blocking the transmission of nerve impulses. In 1931, Kirschner used a special puncture needle to puncture the semilunar ganglion and then passed a small amount of electric current to coagulate the nerve cells in the semilunar ganglion, called electrocoagulation. Because of the high recurrence rate and serious complications including blindness and death, it was later improved, mainly by reducing the current to reduce complications. It was not until 1965 that Sweet invented the differential radiofrequency heating device, which improved the method to the so-called radiofrequency therapy. After successful puncture, the radiofrequency generator is used to slowly heat up the current, increasing by 5℃ every 2 minutes, usually 50℃ can cause heavy hyperalgesia, and the pain sensation disappears at 70℃. The mechanism is that when the temperature is increased to 70-75℃, the relatively fine Aδ and C fibers, which conduct nociception, lose their conduction function due to degeneration, but the coarse fibers, which conduct tactile sensation, can still be preserved, thus achieving the effect of no pain and preserving tactile sensation, and avoiding comorbidities such as corneal ulcer. The difference in temperature tolerance of different nerve fibers was used to selectively destroy the nociceptive nerve fibers in the semilunar ganglion, while preserving the tactile nerve fibers that are more resistant to heat.