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Acta Neurochirurgica

, Volume 161, Issue 5, pp 935–938 | Cite as

ioCT-guided percutaneous radiofrequency ablation for trigeminal neuralgia: how I do it

  • Heinrich Weßling
  • Sven DudaEmail author
How I Do it - Functional Neurosurgery - Pain
  • 104 Downloads
Part of the following topical collections:
  1. Functional Neurosurgery – Pain

Abstract

Background

Percutaneous trigeminal nerve rhizotomy is usually performed by free-handed puncture of the foramen ovale under radiographic control with the patient kept semiconscious. The procedure has thus been reported to be highly uncomfortable for both the patient and surgeon. To our knowledge, this is the first description of a technique that includes precise navigated, CT-guided puncture of the foramen with the patient in general anesthesia and confirmation of needle placement by intraoperative CT.

Method

Radiofrequency ablation of the trigeminal nerve was guided by intraoperative CT navigation with neuromonitoring of trigeminal nerve function. The patient was kept under general anesthesia during the procedure.

Conclusion

CT-guided percutaneous trigeminal nerve rhizotomy is a safe and efficient treatment strategy for the management of trigeminal neuralgia without the need of the patient being in a semiconscious state.

Keywords

Intraoperative computed tomography Trigeminal neuralgia Percutaneous rhizotomy Radiofrequency thermocoagulation 

Notes

Acknowledgements

We would like to thank our patients for providing their anonymous data, and the press and information center of the medical service of the German Armed Forces for the photo documentation of the operative procedure.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Informed consent

Informed consent was obtained from all patients whose treatment data were included in the paper or from their legal representatives

Supplementary material

ESM 1

ioCT-guided percutaneous radiofrequency ablation of the trigeminal nerve is shown stepwise in a patient with TGN of the left trigeminal nerve (MP4 42,926 kb)

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Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of NeurosurgeryHospital of the German Federal Armed ForcesWesterstedeGermany

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