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

Abstract

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.

Optimization of Curvilinear Needle Trajectories for Transforamenal Hippocampotomy

“…22,23 Several research groups have also performed frameless stereotactic cannulation of the foramen ovale for trigeminal rhizotomy. 24,25 Similarly, for diagnosis and surgical treatment of drug-refractory epilepsy, Ortler et al reported an optically-tracked aiming device and noninvasive maxillary fixation system called the Vogele-Bale-Hohner (VBH) head holder. 26,27 This setup facilitates placement of foramen ovale depth electrodes and also mitigates the risk of entering no-go zones like the carotid artery during cannulation.…”

The size of the foramen ovale regarding to the presence and absence of the emissary sphenoidal foramen: is there any relationship between them?

“…As regards FO length, the higher values were recorded by Patil et al [27] and Murugan and Saheb [22], while lower values were found by Kaplan et al [16], Natsis et al [23], Lang et al [17] and Agarwal and Gupta [1]. As regards FO width, the highest values were reported by Lin et al [20] and Yanagi [43] and the lowest values were detected by Ray et al [29]. Wood-Jones [42] supported that in cases of ESF existence, the FO venous part may be replaced by the sphenoidal emissary vein.…”

“…Anteromedial and in close proximity to the FO, the small inconstant emissary sphenoidal foramen (ESF), largely known as foramen Vesalius (or foramen venosum) is located and it always transmits an emissary vein, also connecting pterygoid venous plexus with the cavernous sinus [13,20,39]. It is a reasonable assumption that any change of the volume and shape of the venous plexus may alter FO shape and size.…”

Application of MRI and intraoperative CT fusion images with integrated neuronavigation in percutaneous radiofrequency trigeminal rhizotomy

“…A clinical series proposed a multi-array electrode mapping method to localize the needle tip [9]. The use of iCT with integrated neuronavigation technology in our previous series successfully decreased procedure time and perioperative morbidities [10]. There is still a lack of information on the precise location of the trigeminal ganglion and internal carotid artery on CT imaging.…”