Cryotherapy for Trigeminal Neuralgia

Abstract

Cryotherapy means treating with cold. Cold causes reversible ablation of peripheral nerves and provide pain relief. The utility of cooling therapy is known since the time of Hippocrates [1]. James Arnott (1797–1883), an English physician, first published work on use of cold for treatment of pain in breast, skin and uterine cancers. Due to makeshift agents used and vague technique of delivery, the modality remained less popular. Irving S Cooper, a neurosurgeon contributed enormously to cryosurgery by designing a cryoprobe utilizing liquid nitrogen. The probe could attain a temperature of −196 °C and was used to freeze thalamus for treatment of Parkinson’s disease and other movement disorders [2]. Thereafter, liquid nitrogen became popular and was used across many specialities. The advent of cryoprobe enabled clinicians to precisely control area of lesion and also minimise destruction to neighbouring tissues. Lloyd et al. (1976) used it to treat facial pain and found it useful in patients with TGN [3]. Thereafter, its benefit for relieving chronic facial pain especially due TGN was reported by many clinicians [4, 5].