Frameless navigation-guided percutaneous rhizotomy of the trigeminal nerve: an appraisal of the literature

Pérez-Bovet, Jordi; Cardera, José Luís Caro; Muñoz, J. Rimbau

doi:10.1007/s10143-021-01575-5

Cited by 3 publications

(4 citation statements)

References 24 publications

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“…In patients with MS who have been treated with Gamma Knife radiosurgery, TN treatment with balloon compression can be performed, but the foramen ovale may be more difficult to identify due to radiation-induced adhesions. CT-guided percutaneous rhizotomy or neuro-navigation systems may facilitate needle placement and reduce the risk of complications in such cases ( Pérez-Bovet et al, 2022 ). Having an adequate anatomical localization is crucial during the procedure, as the puncture of unwanted neuro-vascular structures can result in various complications such as cranial nerve palsy, cerebrospinal fluid leak, bradycardia, carotid-cavernous fistula, intracranial hemorrhage, and others ( Xia et al, 2022 ) Meuwly et al, 2015 .…”

Section: Discussionmentioning

confidence: 99%

Frame navigation guided percutaneous balloon compression for intractable trigeminal neuralgia secondary to multiple sclerosis

Valerio Pascua,

Mantilla Farfan,

Fernandez

et al. 2024

Brain and Spine

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Section: Discussionmentioning

confidence: 99%

Frame navigation guided percutaneous balloon compression for intractable trigeminal neuralgia secondary to multiple sclerosis

Valerio Pascua,

Mantilla Farfan,

Fernandez

et al. 2024

Brain and Spine

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“…The development of digital medicine provides us with new ideas and methods to solve this problem. Previous studies have reported various other methods, such as the use of navigation (20)(21)(22)36) and guide plates (23)(24)(25)(37)(38)(39) in the clinical setting. We also used methods such as electromagnetic navigation and mask-like guide plates for radiofrequency thermocoagulation.…”

Section: Discussionmentioning

confidence: 99%

“…This method also exposes surgeons to environmental radiation. Various other methods, such as navigation (20)(21)(22) and guide plates (23)(24)(25), have also been used in the clinical setting. Many previous studies have used a guide plate for radiofrequency or microsphere compression treatment, but without exception, they have used a facial contour-based design (24,(26)(27)(28).…”

Section: Introductionmentioning

confidence: 99%

Personalized tooth-supported digital guide plate used in the treatment of trigeminal neuralgia with balloon compression

Wei¹,

Wang²,

Han³

et al. 2022

Ann Transl Med

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Background: Balloon compression (BC) is a simple and effective operation to treat trigeminal neuralgia (TN). The most difficult procedure in BC is related to fast and accurate foramen ovale (FO) insertion. In this study, we introduced a new method incorporating a personalized tooth-supported digital guide plate to reduce patient trauma, improve the accuracy and the success rate of insertion, and reduce surgeons' radiation exposure.Methods: In total, 15 TN patients aged 55-70 years were recruited between January 2019 and November 2020 and retrospectively analyzed. Before the operation, based on Mimics 3D reconstruction and the modeling of patients' maxillary teeth, personalized tooth-supported digital guide plates were designed and 3D printed. All operational procedures were simulated. Then, all patients underwent BC with a personalized tooth-supported digital guide plate.Results: In the study, guide plate insertion was completed within 60 seconds for all patients. Puncturing time was limited to 5 seconds. Successful insertion into the FO was achieved in 1 attempt for all 15 participants. No patients required more than 3 postinsertion adjustments to obtain a pear-shaped balloon.There were no postoperative complications, such as cerebrospinal fluid leakage, intracranial infection, or visual acuity change. The trigger points, attack frequency per day, attack duration, and Barrow Neurological Institute (BNI) pain intensity scores of all 15 participants were significantly improved postoperation.The visual analog scale (VAS) score significantly decreased postoperation compared with that obtained preoperation (all P<0.001) and gradually decreased with the extension of follow-up time.Conclusions: By applying a personalized tooth-supported digital guide plate, we can significantly avoid the use of an incision outside the mouth, decrease the difficulty of FO insertion, and reduce patient trauma. The operation is more suitable for novice surgeons and protects surgeons from the harm of radiation. This new technology may improve the success rate and accuracy of FO insertion, although a multicenter, large sample, randomized controlled trial is needed.

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“…Currently, neurosurgical navigation techniques are reported to be the optimal solution for achieving precise puncture of the foramen ovale, which can assist in determining anatomical location and guiding surgical operations intraoperatively ( 29 ). Jordi Pérez-Bovet et al ( 30 ) summarized all of the MEDLINE database of Pubmed involving percutaneous puncture (PR) guided by frameless neuronavigation for trigeminal neuralgia references, reported remission rates of 83%–100% after frameless neuronavigation-guided PBC, but there were significant differences in recurrence rates at follow-up, with 9.8%–64% over 1.4–5 years of follow-up. Postoperatively, 1.5%–19% had hyperalgesia and 6.2%–10.8% had masticatory muscle weakness, and only one other complication was reported with postoperative loss of corneal sensation.…”

Section: Discussionmentioning

confidence: 99%

Clinical study on the treatment of primary trigeminal neuralgia by robot-assisted percutaneous balloon compression

et al. 2022

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BackgroundC-arm-guided percutaneous puncture balloon compression alone has risk factors of puncture failure, complications, and poor prognosis. Robot-assisted PBC can effectively increase the one-time puncture success rate and improve the safety of the procedure. However, evidence on the superiority of robot-assisted PBC over C-arm-guided PBC alone remains relatively limited.MethodsRetrospective analysis The clinical data of 60 patients with trigeminal neuralgia aged 60 years or older in the Department of Neurosurgery of the Fourth Hospital of Harbin Medical University from January 2021 to October 2021. There were 29 males and 31 females, and the patients’ ages ranged from 60 to 79 years, with an average of 71.63 ± 5.12 years. Two groups were divided according to the surgical method, the C-arm guidance-only group (30 cases, n = 30) and the robot-assisted group (30 cases, n = 30). The success rate of first puncture, total operation time, number of “pear-shaped” balloons, number of C-arm x-ray scans, and immediate postoperative relief rate were recorded in both groups, and follow-up was performed to evaluate the postoperative results and complications. The overall evaluation of postoperative results and complications was performed.ResultsIntraoperative balloon compression was successfully completed in all 60 patients, and the first puncture success rate was higher in the robot-assisted group than in the simple C-arm group, with a significant difference between the two groups (P < 0.001). In terms of intraoperative balloon morphology, the number of “pear-shaped” balloons was higher in the PBC than in the C-arm-only PBC group, with a significant difference between the two groups (P < 0.005). The degree of immediate postoperative remission in the robotic group was 0 VAS score, which was not statistically significant in both groups (P > 0.05). By the final follow-up, the mean VAS score of the robot-assisted group was lower than that of the simple C-arm group, and both were statistically significant (P < 0.05); complications of masticatory muscle weakness or abnormal facial sensation occurred in both groups after surgery, but the number of cases in the robot-assisted group was less than that of the simple C-arm group.ConclusionRobot-assisted PBC is better than PBC with a C-arm x-ray machine in terms of first puncture success rate, number of intraoperative balloon “pear-shaped” cases, number of C-arm x-ray scans and short-term efficacy.

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Frameless navigation-guided percutaneous rhizotomy of the trigeminal nerve: an appraisal of the literature

Cited by 3 publications

References 24 publications

Frame navigation guided percutaneous balloon compression for intractable trigeminal neuralgia secondary to multiple sclerosis

Frame navigation guided percutaneous balloon compression for intractable trigeminal neuralgia secondary to multiple sclerosis

Personalized tooth-supported digital guide plate used in the treatment of trigeminal neuralgia with balloon compression

Clinical study on the treatment of primary trigeminal neuralgia by robot-assisted percutaneous balloon compression

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