Anthony Wiggins1, Megan Lonie2, Iona Pimentil2, Nicola Newall2, Peter Bodkin3, Asha Venkatesh2. 1. Department of Neurosurgery, Aberdeen Royal Infirmary, Foresterhill, Aberdeen, AB25 2ZN, UK. anwiggins77@hotmail.com. 2. University of Aberdeen, Aberdeen, UK. 3. Department of Neurosurgery, Aberdeen Royal Infirmary, Foresterhill, Aberdeen, AB25 2ZN, UK.
Abstract
BACKGROUND: Several techniques have been described for the percutaneous treatment of trigeminal neuralgia; however, each has significant drawbacks. We propose a new technique for percutaneous balloon compression of the trigeminal ganglion and distal trigeminal nerve using electromagnetic (EM) neuronavigation. METHODS: The procedure was performed in 17 consecutive patients with trigeminal neuralgia. Patients were then followed up with telephone interview. We also performed a cadaveric validation study to further investigate the accuracy of the technique using dye. RESULTS: Excellent clinical outcomes were achieved with a reduction in the median pain score from 10 out of 10 to 0 out of 10 following the procedure. The cadaveric study also demonstrated a high rate of foramen ovale cannulation. CONCLUSION: EM-based targeting of the foramen ovale and balloon inflation within Meckel's cave is a quick, reproducible and straightforward technique for the percutaneous treatment of trigeminal neuralgia.
BACKGROUND: Several techniques have been described for the percutaneous treatment of trigeminal neuralgia; however, each has significant drawbacks. We propose a new technique for percutaneous balloon compression of the trigeminal ganglion and distal trigeminal nerve using electromagnetic (EM) neuronavigation. METHODS: The procedure was performed in 17 consecutive patients with trigeminal neuralgia. Patients were then followed up with telephone interview. We also performed a cadaveric validation study to further investigate the accuracy of the technique using dye. RESULTS: Excellent clinical outcomes were achieved with a reduction in the median pain score from 10 out of 10 to 0 out of 10 following the procedure. The cadaveric study also demonstrated a high rate of foramen ovale cannulation. CONCLUSION: EM-based targeting of the foramen ovale and balloon inflation within Meckel's cave is a quick, reproducible and straightforward technique for the percutaneous treatment of trigeminal neuralgia.