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Foramen ovale cannulation guided by intra-operative computed tomography with integrated neuronavigation for the treatment of trigeminal neuralgia

  • Clinical Article
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Abstract

Background

Radiofrequency rhizotomy of the Gasserian ganglion for the treatment of trigeminal neuralgia via percutaneous cannulation of the foramen ovale is facilitated by various localization modalities. In our preliminary study, we described the feasibility of computed tomography (CT) using an integrated neuronavigation system to cannulate the foramen ovale.

Methods

Analysis was performed on 42 consecutive patients who underwent cannulation of the foramen ovale for radiofrequency trigeminal rhizotomy guided by CT using an integrated neuronavigation system. The reproducibility and safety of the neuronavigation-guided procedure were evaluated.

Results

Overall, the average dimension of the foramen ovale was 7.1 (1.5) × 4.7 (1.1) mm, and it was successfully cannulated by neuronavigation guidance in 31 (73.8%) patients with a mean cannulation time of 3.1 (0.7) min and an overall procedure time of 68.2 (16.4) min. The remaining 11 (26.2%) patients required subsequent CT guidance for successful puncture of the foramen ovale.

Conclusions

These data demonstrate that neuronavigation-guided cannulation of the foramen ovale can be executed both quickly and safely on an outpatient basis. Additionally, the use of CT with integrated neuronavigation technology provides superior visual-spatial information compared to conventional fluoroscopy, the process of CT scanning, object planning, and neuronavigation-guided intervention can be completed in the same locale, and its application is easy to master and has the potential to enhance procedure tolerability of awake patients.

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Acknowledgments

We thank Yi-Chen Lee for help in performing this operative technique.

Conflicts of interest

None.

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Authors and Affiliations

  1. Department of Neurosurgery, Chang Gung Memorial Hospital, 6 Sec West, Chia Pu Rd, Pu Tz City, Chia-Yi, Taiwan

    Martin Hsiu-Chu Lin, Ming-Hsueh Lee, Ting-Chung Wang, Yu-Kai Cheng, Chen-Hsing Su, Chia-Mao Chang & Jen-Tsung Yang

  2. College of Medicine, Chang Gung University, Tao-Yuan, Taiwan

    Jen-Tsung Yang

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  1. Martin Hsiu-Chu Lin
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  2. Ming-Hsueh Lee
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Correspondence to Jen-Tsung Yang.

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This work has not been presented nor is it under evaluation for publication elsewhere.

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Lin, M.HC., Lee, MH., Wang, TC. et al. Foramen ovale cannulation guided by intra-operative computed tomography with integrated neuronavigation for the treatment of trigeminal neuralgia. Acta Neurochir 153, 1593–1599 (2011). https://doi.org/10.1007/s00701-011-1009-2

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  • DOI: https://doi.org/10.1007/s00701-011-1009-2

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