Comprehensive analysis and treatment of intraoral thyroglossal duct cysts with intraoperative techniques: a 7-case series review in a tertiary care center.

OBJECTIVE: Intraoral thyroglossal duct cyst is a relatively rare clinical disease. This article reviews the diagnosis and treatment process of 7 patients and explores the clinical characteristics of diagnosis and treatment of intraoral thyroglossal duct cyst in combination with past literature reports. METHOD: A retrospective analysis was conducted on 7 cases of intraoral thyroglossal duct cyst admitted to the Otolaryngology ward of Dalian Municipal Central Hospital from January 2017 to January 2024. The cases were recorded in terms of gender, age, symptoms, physical signs, radiological examinations, surgical methods, and postoperative complications. All cases were followed up, and the latest follow-up results were recorded. RESULTS: Among the 7 cases, 6 patients underwent laryngoscopic and radiological examinations before surgery, and 1 child was found to have a cyst during surgery. All cases were diagnosed with intraoral thyroglossal duct cyst and treated with plasma radiofrequency surgery. None of the patients had postoperative complications, and no recurrence was found in the six-month follow-up after discharge. CONCLUSION: Intraoral thyroglossal duct cyst is rare in clinical practice. It is important to pay attention to its differential diagnosis clinically, and careful review of images is required before surgery. Cryoablation with low-temperature plasma radiofrequency is not only minimally invasive and has a quick recovery but also has few complications and a low recurrence rate. It is a safe and effective treatment method that is worthy of clinical promotion. LEVEL OF EVIDENCE: Level 3.

Low-Temperature Plasma Radiofrequency Ablation for Congenital Epiglottic Cysts.

Objectives: Congenital epiglottic cysts are rare disorders of the larynx with symptoms such as laryngeal stridor and inspiratory dyspnea and are life-threatening in severe cases. This study aimed to investigate the usefulness of low-temperature plasma radiofrequency ablation for congenital epiglottic cysts and provide a reference for clinicians to develop treatment options. Methods: The clinical data of children (n = 7, 4 males and 3 females) with congenital epiglottic cysts, who were admitted to the Second Affiliated Hospital of Wenzhou Medical University and Yuying Children's Hospital from March 2018 to March 2023, were analyzed retrospectively. Following preoperative examinations, all patients underwent low-temperature plasma radiofrequency ablation under general anesthesia, and the curative effect was evaluated. Following surgery, regular patient follow-up examinations were conducted to monitor recurrence. Results: The age at the time of operation ranged from 1 day to 99 days, with an average of 37.57 ± 35.01 days. The surgical procedure was successfully completed in all the children; dyspnea disappeared and no surgical complications were observed. In addition, during the postoperative follow-up period of 6 months to 5 years, recurrence was not observed. Conclusions: Low-temperature plasma radiofrequency ablation is a safe and effective procedure for treating congenital epiglottic cysts and deserves clinical application and promotion.

Evaluation of the efficacy and safety of day surgery for cervical disc herniation treated with low temperature plasma radiofrequency ablation.

PURPOSE: The purpose of this study was to evaluate and compare the clinical efficacy of patients with cervical disc herniation (CDH) treated by low-temperature plasma radiofrequency ablation (LTP-RFA) as day surgery with traditional inpatients. METHODS: According to the selection criteria, single-segment mild to moderate CDH patients who received LTP-RFA from January 2020 to December 2021 were divided into day surgery procedure (DSP) group and a traditional inpatient procedure (TIP) group. The visual analogue score (VAS) and modified Japanese Orthopedic Association score (mJOA) of neurological function of patients in the two groups were recorded at the time of preoperative, and one day, three months, six months after surgery and the last follow-up respectively. The gender, age, responsible segment, surgical complications, hospitalization time, hospitalization expenses, and patient satisfaction were recorded and analyzed for both groups. The modified Macnab standard was used to evaluate the postoperative efficacy at one month and six months after operation. RESULTS: A total of 127 patients (75 in DSP;52 in TIP) with complete data were enrolled and completed six month follow-up. There were no statistically significant pre-treatment VAS scores and mJOA scores in the two groups (P>0.05). The postoperative VAS and mJOA scores in both groups were improved after surgery (P<0.05). However, there was no significant difference in VAS scores and mJOA scores between the two groups in the same postoperative period (all P > 0.05). The efficacy of MacNab was similar one month and six months after operation (P > 0.05). The hospitalization time and hospitalization cost were significantly lower in DSP group (all P<0.05). As the treatment effects were comparable, patients in both groups were similarly satisfied at discharge. CONCLUSION: LTP-RFA is an effective method for the treatment of mild to moderate CDH. We suggest that the application of LTP-RFA in DSP for mild to moderate CDH is worthy of wide application.

A novel endoscopic nasopharyngectomy by low-temperature plasma radiofrequency ablation in localized recurrent nasopharyngeal carcinoma.

OBJECTIVE: Endoscopic nasopharyngectomy (ENPG) with en bloc resection has been well accepted in resectable localized recurrent nasopharyngeal carcinoma (rNPC), but it is a difficult technique to master for most otorhinolaryngology head and neck surgeons. Ablation surgery is a new and simplified method to remove tumors. We designed a novel method using low-temperature plasma radiofrequency ablation (LPRA) and evaluated the survival benefit. METHODS: A total of 56 localized rNPC patients were explained in detail and retrospectively analyzed. The surgery method was ablated from the resection margin to the center of the tumor. The postmetastatic overall survival (OS), local relapse-free survival (LRFS) rate, progression-free survival (PFS) and distant metastasis-free survival (DMFS) were analyzed using the Kaplan-Meier method and compared by the log-rank test. RESULTS: All surgeries were successfully performed without any severe postoperative complications or deaths. The median operation time of ablation and harvested NSFF respectively were 29 min (range, 15-100 min) and 101 min (range, 30-180 min). The average number of hospital days postoperation was 3 days (range, 2-5 days). All cases (100.0%) had radical ablation with negative resection margins. The nasopharyngeal defects were completely re-epithelialized in 54 (96.4%) patients. As of the data cutoff (September 3, 2023), the median follow-up time was 44.3 months (range, 17.1-52.7 months, 95% CI: 40.4-48.2). The 3-year OS, LRFS, PFS and DMFS of the entire cohort were 92.9% (95% CI: 0.862-0.996), 89.3% (95% CI: 0.813-0.973), 87.5% (95% CI: 0.789-0.961), and 92.9% (95% CI: 0.862-0.996), respectively. Cycles of radiotherapy were independent risk factors for OS (p = 0.003; HR, 32.041; 95% CI: 3.365-305.064), LRFS (p = 0.002; HR, 10.762; 95% CI: 2.440-47.459), PFS (p = 0.004; HR, 7.457; 95% CI: 1.925-28.877), and DMFS (p = 0.002; HR, 34.776; 95% CI: 3.806-317.799). CONCLUSION: Radical endoscopic nasopharyngectomy by using low-temperature plasma radiofrequency ablation is a novel, safe and simplified method to master and disseminate for treating resectable rNPC. However, further data and longer follow-up time are needed to prove its efficacy.

CO2 laser combined with low-temperature plasma radiofrequency ablation promotes recovery of swallowing function in elderly patients with early glottic carcinoma.

OBJECTIVE: This study was designed to determine the effect of CO2 laser combined with low-temperature plasma radiofrequency ablation (LPRA) on swallowing function and prognosis in elderly patients with early glottic laryngeal cancer (GLC). METHODS: The clinical data of 115 elderly patients with early GLC treated in General Hospital of Daqing Oil Field from May 2013 to September 2015 were retrospectively analyzed. These patients were assigned to a research group or control group according to different therapeutic regimen. Totally 56 cases treated with CO2 laser resection were assigned to the control group, and 59 cases treated with CO2 laser combined with LPRA were assigned to the research group. The hospital stay, postoperative pain, mucosal recovery score, postoperative complications, swallowing function, vocal function, and 5-year recurrence rate were compared between the two groups. Independent risk factors for 5-year recurrence in patients were analyzed by multivariate logistic regression. RESULTS: The research group was significantly superior to the control group in terms of hospital stay, postoperative pain, and mucosal recovery score (P<0.05), and the postoperative complication rate was not significantly different between the two groups (P>0.05). After treatment, the research group showed better swallowing function and vocal function than the control group, and the 5-year recurrence rate of the two groups was similar (P=0.288). Multivariate logistic regression analysis identified higher age, lower differentiation, and presence of a cumulative anterior commissure as independent risk factors for recurrence. CONCLUSION: CO2 laser combined with LPRA can provide relatively high clinical efficacy for early GLC in the elderly, after which patients' swallowing function and vocal function recover quickly, but the long-term benefit of adding LPRA is not evident.

A clinical study of C arm-guided selective spinal nerve block combined with low-temperature plasma radiofrequency ablation of dorsal root ganglion in the treatment of zoster-related neuralgia.

Background: This study evaluated the analgesic efficacy and psychological response of low-temperature plasma ablation of dorsal root ganglion (DRG) combined with selective spinal nerve block in patients with acute or subacute zoster-related neuralgia (ZRN). Methods: Totally 90 ZRN patients were randomly and evenly divided into three groups. Treatment was given to Group A using C arm-guided selective spinal nerve block (C-SSVB), Group B using C-SSVB and pulsed radiofrequency (PRF), and Group C using C-SSVB and low-temperature plasma ablation of the DRG. The outcomes were examined using the Visual Analog Scale (VAS). Anxiety and depression of patients were evaluated using the Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS). Quality of life was assessed using the Pittsburgh Sleep Quality Index (PSQI) and postoperative Satisfaction scale. In addition, data on adverse events and medication usage rates were collected. Results: The 90 patients were eligible for this study. The three treatments reduced VAS scores with no significant difference between groups A and B at the same time points; however, group B tended to have numerically lower VAS scores. Comparatively, group C had significantly reduced VAS scores on day 1 and 1 month after treatment compared with the other two groups. In terms of the decreasing SAS, SDS and PSQI scores, all the three treatments improved the anxiety, depression and sleep quality of the patients. In addition, significant alleviation in anxiety was found in group C compared with group A at all- time points. However, there was no statistically significant difference among the three groups in treatment-related adverse events that mainly focused on puncture pain at the surgical-site, skin numbness and medication usage rates. Conclusions: C-SSVB and LTPRA of DRG will be considered as a promising treatment option for ZRN patients if those results can be confirmed after further validation.

Therapeutic effects of low-temperature plasma radiofrequency ablation and partial laryngectomy for glottis cancer: A comparative study.

Objective: To compare the therapeutic effects of low-temperature plasma radiofrequency ablation and partial laryngectomy in the treatment of early glottis carcinoma. Methods: Clinical data of 80 patients with early glottis carcinoma treated in our hospital from June 2019 to January 2021 were analyzed. Patients were retrospectively divided into two groups based on the type of intervention. Forty patients received partial laryngectomy (Control group) and 40 patients received low-temperature plasma radiofrequency ablation (Observation group). Surgical indexes, length of hospital stay, postoperative complications, and visual analog scale (VAS) score of postoperative pain of patients in the two groups were compared. Postoperative stress response indexes, clinical efficacy, and postoperative recovery in two groups were compared and analyzed. Result: The operation time, hospital stay, intraoperative bleeding, and the incidence of postoperative complications in the observation group were significantly lower than those in the Control group (P<0.05). The postoperative pain VAS scores, Levels of malondialdehyde (MDA) and glutathione (GSH) in the observation group were significantly lower than those in the control group (P<0.05), while the level of nitro tyrosine (3-NT) and superoxide dismutase (SOD) were significantly higher than that in the control group (P<0.05). After a one-year follow-up, the excellent and good rate of pronunciation function in the observation group (95%) was significantly higher than control group (75%) (P<0.05). Conclusions: Low-temperature plasma radiofrequency ablation in the treatment of early glottis carcinoma is associated with less trauma, short operation time, less bleeding, short hospital stay and low postoperative stress reaction rate. Compared with partial laryngectomy, it has higher safety and better postoperative vocal cord function recovery.

[Analysis of risk factors for re-operation due to postoperative haemorrhage following coblation-assisted tonsillectomy].

Objective:To investigate the risk factors for re-operation due to postoperative haemorrhage following coblation-assisted tonsillectomy. Methods:The clinical data of 135 patients with haemorrhage after coblation-assisted tonsillectomy in our hospital from January 2015 to May 2022 were collected, According to the patients received reoperation after tonsillectomy or not, all patients were divided into the reoperation group （n=43） and non-reoperation group （n=92）,clinical data were compared between the two groups. Results:Univariate analysis showed that there was no significant difference in gender, age, postoperative intravenous glucocorticoid use, diabetes and hypertension between the two groups（P>0.05）, Univariate and multivariate factor analyses showed that early haemorrhage, obvious hemorrhage points were independent risk factors for re-operation due to postoperative haemorrhage（P<0.05）. Conclusion:Early haemorrhage and obvious hemorrhage points are independent risk factors for re-operation due to postoperative haemorrhage following coblation-assisted tonsillectomy.

Preliminary dynamic observation of wound healing after low-temperature plasma radiofrequency ablation for laryngeal leukoplakia.

BACKGROUND: Low-temperature plasma ablation (LTPA) is an emerging technique for laryngeal leukoplakia (LL). OBJECTIVE: To initially observe the healing process of trauma after LTPA for LL. MATERIALS AND METHODS: Seventeen patients who underwent LTPA for LL were collected, and the degrees of wound healing were analyzed. RESULTS: Only 1 patient in who dysbiosis of the pharyngeal flora was induced by self-administered hormone nebulization treatment during the follow-up period. In the remaining patients, the wound healing was characterized by a crater-shaped defect on the vocal folds surface with pseudo-membranes, congestion, and mild edema on postoperative day 1. These symptoms became worse on postoperative day 7. On postoperative day 15, the pseudo-membrane was fully formed and some patients had granulomatous swelling of the vocal cords. These symptoms became better and better on postoperative day 30 and day 45. On postoperative day 60, the mucosa of the vocal folds had essentially returned to normal. On postoperative day 90, the vocal folds morphology and function had recovered well. CONCLUSION: It takes 2-3 months for the wound to heal completely after LTPA for LL. SIGNIFICANCE: A proper understanding of the wound healing process can reduce unnecessary surgical and pharmacologic interventions and avoid excessive treatment.

The efficacy of cisplatin and low-temperature plasma radiofrequency ablation in advanced laryngeal cancer patients and on the serum survivin levels.

OBJECTIVE: To investigate the effect of cisplatin injections combined with low-temperature plasma radiofrequency ablation on the clinical efficacy and serum survivin levels in advanced laryngeal cancer patients. METHODS: A total of 42 patients with locally advanced laryngeal cancer treated in our hospital from January 2018 to June 2020 were recruited as the study cohort and placed in a control group (21 cases) or a treatment group (21 cases) according to the medication administered to each patient. The patients in the control group were treated with CO2 laser resections under laryngoscopy combined with cisplatin injections, and the patients in the observation group were treated with low-temperature plasma radiofrequency ablation combined with cisplatin injections. The clinical efficacies in the two groups were observed and the WHOQOL-BREF scores, tumor marker levels, and serum survivin levels were compared. RESULTS: After the treatment, the ORR and CBR in the control group were 33.3% and 61.9%, respectively, levels that were significantly lower than the 66.7% and 90.5% in the observation group (P<0.05). The observation group's physiological, psychological, and social relations dimension scores were significantly higher than the corresponding scores in the control group (P<0.05). The tumor markers in the observation group were significantly lower in the serum CA72-4, CA19-9, and SCC-Ag levels than they were in the control group (P<0.05). The observation group exhibited lower serum survivin levels than the control group (P<0.05). Conclusion Cisplatin injections combined with low-temperature plasma radiofrequency ablation has a significant effect on the treatment of locally advanced laryngeal cancer. It can improve patients' quality of life, reduce the tumor marker levels in the body, and inhibit the serum survivin levels.

Low-temperature plasma radiofrequency ablation for the management of refractory cluster headache.

INTRODUCTION: Although the sphenopalatine ganglion (SPG) has been considered a site of therapeutic potential for cluster headache (CH), the optimal technique of SPG is still to be determined. Low-temperature plasma radiofrequency ablation (LTPRA) has been proposed as an alternative treatment for several neuropathic pain diseases. AIM: To evaluate the effect of LTPRA of SPG in treating chronic and episodic CH. MATERIAL AND METHODS: The patients with CH, who achieved temporary pain relief following SPG block, treated using LTPRA between January 2015 and October 2017 were reviewed. Seventy-six patients were included: 50 patients suffered from episodic CH and the remaining 26 patients from chronic CH. The primary outcomes were clinical improvement rate, defined as the percentage of partial and complete pain relief results at 1 day, 12 months, and 24 months of follow-up after the operation. RESULTS: Clinical improvement rates were 92.3%, 92.3% and 73.1% in chronic CH and 73.1%, 84% and 68% in episodic CH at each follow-up time point, respectively. 3 chronic CH patients and 7 episodic CH patients showed no pain relief after the operation. Drooping eyelids were found in 2 cases, one recovered at the 3-month follow-up but another one did not in the 24-month follow-up. No serious complications occurred intraoperatively or postoperatively. CONCLUSIONS: LTPRA can be considered an effective and alternative surgical modality in treating patients with chronic and episodic CH, based on SPG block.

Masticatory Dysfunction After Computed Tomography-Guided Plasma Ablation vs. Radiofrequency Ablation on Gasserian Ganglion for Idiopathic Trigeminal Neuralgia: A Randomized Controlled Trial.

OBJECTIVE: We aimed to evaluate masticatory dysfunction after two different types of ablation on the Gasserian ganglion for the treatment of idiopathic trigeminal neuralgia. We hypothesized that low-temperature plasma radiofrequency ablation (LTP-RFA) was noninferior to radiofrequency thermocoagulation (RFT) with respect to initial efficacy. METHODS: In the randomized, single-blind, parallel-group, noninferiority trial, 204 participants with idiopathic trigeminal neuralgia were randomly allocated to receive plasma ablation in the LTP-RFA group and radiofrequency ablation in the RFT group in a 1:1 ratio, with random block sizes of four or six. Participants were examined at baseline (T0), on the day of discharge (T1), and at the 6-month follow-up (T2). The primary end point was the clinincal effective rate in the LTP-RFA group compared with that in the RFT group after intervention on the day of discharge. Noninferiority was prespecified at -10%. RESULTS: The intention-to-treat analysis revealed that the initial efficacy rates were 91.2% in LTP-RFA group and 93.1% in RFT group (rate ratio [RR] = 0.979, 95% confidence interval [CI]: 0.904-1.061, P = 0.795). The difference between the two groups was 1.9% (95% CI: -5.6% to 9.4%), which showed that LTP-RFA demonstrated noninferiority compared with RFT in initial efficacy. Compared with the RFT group, the LTP-RFA group exhibited a significantly greater improvement in the maximum voltage of the masseter muscles with mean differences of 11.40 (95% CI: 10.52 to 12.27, P < 0.001) at T1 and 17.41 (95% CI: 14.68 to 20.13, P < 0.001) at T2, respectively. Similar results were observed for the asymmetry index of occlusion, the maximum voltage of the anterior temporalis, and the activity index of anterior temporalis / masseter muscles. No serious adverse events were observed in either group. CONCLUSIONS: Compared with the RFT group, noninferior efficacy for pain relief and improvement of masticatory function was revealed in the LTP-RFA group.

Efficacy and toxicities of low-temperature plasma radiofrequency ablation for the treatment of laryngomalacia in neonates and infants: a prospective randomized controlled trial.

BACKGROUND: Laryngomalacia is the most common cause of stridor in neonates and infants, and supraglottoplasty is the mainstay of surgical treatment. Although low-temperature plasma radiofrequency ablation (LTP-RFA) using coblation technology has been used for treating laryngomalacia, it is still lack of high-quality clinical evidence. Therefore, we conduct this prospective randomized study to clearly define the role of LTP-RFA for the treatment of laryngomalacia in neonates and infants. METHODS: Between Jan 2017 and Dec 2019, a total of 89 children with laryngomalacia were included for analysis. All patients were initially stratified according to the severity of laryngomalacia. Patients with severe laryngomalacia were randomly assigned to receive LTP-RFA or traditionally surgical supraglottoplasty, while patients with moderate laryngomalacia were assigned to LTP-RFA or observation. The primary end point was the efficacy and toxicities of LTP-RFA by assessing the changes of clinical score and visual analogue scale (VAS) symptom score. The total score was the combination of clinical score with VAS score. RESULTS: Of the 89 children, 40 children presented with severe laryngomalacia, and the remaining 49 children were diagnosed as moderate laryngomalacia. The median age was 68 days (range, 19 to 337 days). For children with severe laryngomalacia, our results showed that LTP-RFA treatment significantly reduced the operative time (5.55±1.66 vs. 18.7±5.31 min, P<0.001), length of hospital stay (6.71±1.15 vs. 7.95±1.55 days, P=0.008) and the amount of intraoperative hemorrhage (1.71±1.79 vs. 4.90±1.82, P<0.001) when compared to traditionally surgical supraglottoplasty, while the treatment efficacy was comparable between LTP-RFA and traditionally surgical supraglottoplasty in terms of changed total score (P=0.322), changed clinical score (P=0.135) and changed VAS symptom score (P=0.559). Additionally, for children with moderate laryngomalacia, LTP-RFA treatment significantly improved the symptom evaluated by total score (P<0.001), clinical score (P<0.001) and VAS symptom score (P<0.001) in comparison with the observation group. Post-operative pneumonia was observed in 10 patients. No surgical related death was reported. CONCLUSIONS: The present study indicated that LTP-RFA was an effective treatment option for both severe and moderate laryngomalacia in neonates and infants with a low intraoperative complication. Long-term outcomes of LTP-RFA for laryngomalacia would be reported in further studies.

Sphenopalatine ganglion-targeted low-temperature plasma radiofrequency ablation in the treatment of refractory cluster headache.

INTRODUCTION: Cluster headache (CH) is a refractory headache. Low-temperature plasma radiofrequency ablation is a relatively novel technique with promising applications in neuropathic pain. It may improve the treatment of CH. AIM: To evaluate the efficacy and safety of sphenopalatine ganglion-targeted low-temperature plasma radiofrequency ablation in the treatment of patients with refractory CH. MATERIAL AND METHODS: A retrospective cohort study including seventy-five patients with refractory cluster headache who underwent computed tomography (CT)-guided sphenopalatine ganglion-targeted low-temperature plasma radiofrequency ablation between January 2015 and December 2017 at the Beijing Xuanwu Hospital was conducted. RESULTS: Effective pain relief rate 3 months after the procedure was 96% with 40 (53.3%) patients achieving complete relief; 32 (42.7%) patients obtained partial relief and 3 (4%) patients showed no relief. The effective pain relief rate two years after the procedure remained as high as 85.3% with 29 (38.6%) achieving complete relief, 35 (46.7%) partial relief and 11 (14.7%) no relief. The procedure proved equally effective for both episodic and chronic cluster headache. Complications including facial numbness, masseter weakness, facial hypoesthesia and cheek hematoma were observed, but all were mild and disappeared within 6 months. CONCLUSIONS: CT-guided low-temperature plasma radiofrequency ablation is an effective and safe strategy for refractory cluster headache. For patients who have not responded to conservative treatment, this minimally invasive intervention is a reliable alternative.

Clinical efficacy comparison of low-temperature plasma radiofrequency ablation and Nd:YAG laser in treating recurrent acquired nasolacrimal duct obstruction.

To evaluate the effectiveness and safety of low-temperature plasma radiofrequency ablation (coblation) and Nd:YAG laser in treating recurrent nasolacrimal duct obstruction. A prospective study was performed on patients who agreed to be treated with coblation or Nd:YAG laser for recurrent nasolacrimal duct obstruction after failed lacrimal Nd:YAG laser combined with silicone intubation. The visual analogue scale (VAS) pain grade was assessed at baseline, immediately, and 3 and 7 days after surgery. The degree of watering, lacrimal passage irrigation, and complications were also evaluated 1 week and 1, 3, and 6 months after surgery. Ninety-five patients who met the criteria for recurrent nasolacrimal duct obstruction from February 2018 to February 2019 were included in this study, with 46 patients receiving coblation and 49 patients Nd:YAG laser. The intraoperative and postoperative (3 days after surgery) VAS pain grades of the patients who received coblation were significantly lower than those who received Nd:YAG laser (P < 0.001). The number of patients in the coblation group who achieved complete clinical relief (no epiphora symptoms with fluent lacrimal passage irrigation) was significantly larger than that in the lacrimal Nd:YAG laser group at 1, 3, and 6 months after surgery (P = 0.033, P = 0.006, P = 0.003, respectively). During the follow-up period, there were no unexpected complications in either group. Compared with Nd:YAG laser, coblation performed well in alleviating pain and maintaining sustained disease relief and may therefore be an alternative to conventional laser or dacryocystorhinostomy surgery in the management of recurrent nasolacrimal duct obstruction.

Comparison of the short-term outcomes after low-temperature plasma radiofrequency ablation (coblation) in the Gasserian ganglion for the treatment of idiopathic trigeminal neuralgia.

Background: Low-temperature plasma radiofrequency ablation (coblation) is a relatively novel technique with promising applications in neuropathic pain. A nerve stimulator was modified and connected to a plasma knife head to solve the problem of accessing the Gasserian ganglion for treatment of trigeminal neuralgia (TN). Objective: To compare the therapeutic effects and short-term outcomes of coblation vs radiofrequency thermocoagulation for the treatment of primary TN. Methods: This was a retrospective cohort study of 217 inpatients who had undergone surgical treatment for primary TN between September 2017 and June 2018 at the Xuanwu Hospital, Capital Medical University. The patients were grouped according to the procedure they selected after an informed comprehensive discussion with their surgeon: the coblation group and the radiofrequency group. Pain, numbness, and muscle atrophy were evaluated before surgery, on the day of surgery, and at 3 days, 5 days, and 3 months after surgery. Results: In the coblation and radiofrequency groups, the pain relief rates were 74.7% and 85.5% on day 1 (P=0.066), 85.3% and 97.3% on day 3 (P=0.003), and 97.7% and 88.2% at 3 months (P=0.134). At 3 months after surgery, 69.3% of the patients in the coblation group and 42.7% in the radiofrequency group had no pain (P<0.001). The multivariable analysis showed that the risk of numbness in the coblation group was independently lower than in the radiofrequency group at 3 months after surgery and (OR=0.243, 95%CI: 0.122-0.484, P<0.001). Three months after the surgery, no recurrence was found in both of the coblation group and the radiofrequency group. Postoperative pain score ≥4 points was considered as a sign of failure this series at 3 months after surgery. The failure rate in coblation group is 2.7% (n=2) and a radiofrequency group is 4.5% (n=5), but there was no statistical difference between the two groups (P=0.703). Conclusion: Coblation could reduce the risk of postoperative numbness in patients with primary TN.