Frameless Stereotactic Cannulation Of The Foramen Ovale For Ablative Treatment Of Trigeminal Neuralgia

Bale, Reto; Laimer, Ilse; Martin, Arno; Schlager, Andreas; Mayr, Christoph; Rieger, Michael; Czermak, Benedikt V.; Kovács, Péter; Widmann, Gerlig

doi:10.1227/01.neu.0000232770.97616.d0

Cited by 48 publications

(91 citation statements)

References 36 publications

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“…A biplane imaging unit could be used instead of a portable monoplane unit to successfully enter the cave. Frameless stereotaxy using a navigating system is helpful for cannulation of the foramen ovale 2) . The catheter may have to be repositioned one or more times until the characteristic pear shape appears.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Balloon Compression of Trigeminal Ganglion for the Treatment of Idiopathic Trigeminal Neuralgia : Experience in 50 Patients

Park

Lee

Kim

et al. 2008

J Korean Neurosurg Soc

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Section: Discussionmentioning

confidence: 99%

Percutaneous Balloon Compression of Trigeminal Ganglion for the Treatment of Idiopathic Trigeminal Neuralgia : Experience in 50 Patients

Park

Lee

Kim

et al. 2008

J Korean Neurosurg Soc

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“…Although the more distant targets yielded slightly larger values, confirming the significant impact of the distance between the registration and target points on the accuracy [7,8,21], even the maximum deviation of 1.2 mm is still within the range (1 to 2 mm) that is often considered ''clinically acceptable'' for navigation system accuracy [1,21,25,26]. Maxillary splint-based systems with extraoral extensions for reference markers have been used previously with sufficient navigational accuracy in neurosurgery (0.29-0.86 mm [17], 0.0-2.0 mm [27]), in sinus surgery (1.56 AE 0.76 mm [28]), and in the temporal region (0.73 AE 0.25 mm [17,29]); however, only a few of these systems have been tested for targets in the lateral skull base region [15,29,30,31]. Bale et al used a mouthpiecebased registration template held in place by a vacuum system to successfully cannulate the foramen ovale [30], but did not test its applicability for Figure 3.…”

Section: Discussionmentioning

confidence: 99%

“…Maxillary splint-based systems with extraoral extensions for reference markers have been used previously with sufficient navigational accuracy in neurosurgery (0.29-0.86 mm [17], 0.0-2.0 mm [27]), in sinus surgery (1.56 AE 0.76 mm [28]), and in the temporal region (0.73 AE 0.25 mm [17,29]); however, only a few of these systems have been tested for targets in the lateral skull base region [15,29,30,31]. Bale et al used a mouthpiecebased registration template held in place by a vacuum system to successfully cannulate the foramen ovale [30], but did not test its applicability for Figure 3. Navigational screenshot.…”

Section: Discussionmentioning

confidence: 99%

Image guided surgery of the lateral skull base: Testing a new dental splint registration device

Ledderose

Hagedorn

Spiegl

et al. 2011

Computer Aided Surgery

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Objective: The widespread use of image guided surgery in the frontolateral skull base region has been limited by the need for a reliable and non-invasive registration procedure that provides sub-millimetric accuracy. We developed and validated preclinically a non-invasive, easy-to-use registration device based on a dental splint with a laterally mounted fiducial carrier. Methods: Repeated accuracy measurements were performed on six titanium target fiducials which were screwed into the lateral skull base region of a cadaver head and could be unequivocally identified both on the CT image and in reality. The system accuracy was evaluated by determining the deviation of the real target position from the position indicated in the CT scan. The accuracy of the dental splint-based registration was compared to that of two standard registration procedures: contour-based laser surface registration and fixed marker registration. Results: The mean accuracy of 0.55 AE 0.28 mm obtained when using the maxillary splint device was similar to that obtained with the ''gold standard'' registration using bone-implanted markers (0.33 AE 0.26 mm), while being clearly superior to that obtained with contour-based laser surface registration (1.91 AE 0.74 mm). Conclusions: Registration using the non-invasively fixed maxillary fiducial platform can provide sub-millimetric accuracy in the lateral skull base region. In vivo validation may prove dental splint-based registration to be an accurate and non-invasive alternative option for image guided surgery of the lateral skull base, and may facilitate the application of navigation systems in this delicate region.

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“…Surgical navigation systems have recently been adapted to improve trajectory planning and targeting [2][3][4][5]. Navigation systems allow real-time tracking of surgical instruments projected in the patient's corresponding CT or MR images.…”

Section: Introductionmentioning

confidence: 99%

Accuracy and diagnostic yield of CT-guided stereotactic liver biopsy of primary and secondary liver tumors

Schullian

Widmann

Lang

et al. 2011

Computer Aided Surgery

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Objective: CT-guided biopsy still plays a decisive role in the management of liver tumors, especially if the lesions are not visible or accessible by ultrasound. As CT-guided stereotaxy appears to be a very accurate targeting technique, the aim of this study was to evaluate the targeting accuracy, diagnostic yield, and complications of CT-guided stereotactic liver biopsy of primary and secondary liver tumors. Methods and Materials: Prior to stereotactic liver biopsy, patients under general anesthesia were immobilized using a vacuum cushion. Respiratory motion was controlled by temporary disconnections of the endotracheal tube. An opticalbased navigation system was used for 3D trajectory planning and placement of a 15-G coaxial needle via a stereotactic aiming device. The histological samples were obtained using a 16-G Tru-Cut TM biopsy needle system. For evaluation of targeting accuracy the control CT image with the needles in place was fused with the planning CT image. The lateral error at the tip and skin entry point and the angular error were calculated. In addition, the skin-to-liver-surface (SL) distance, the needle-to-liver-surface (NL) angle, and the presence of liver cirrhosis were evaluated. The diagnostic yield was evaluated by histological reports from the institutional pathologists. Results: The median lateral error was 2.5 mm (range: 0-6.5 mm) at the needle entry point and 3.2 mm (range: 0.01-9.4 mm) at the needle tip. The median angular error was 1.06(range: 0-6.64 ). Liver cirrhosis, NL angle and SL distance showed no significant impact on the targeting accuracy. Forty-five of the 46 liver biopsies (97.8%) were diagnostic according to the histological reports. No puncture-related complications such as bleeding or perforation of intestinal organs or lung tissue were recorded.

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Frameless Stereotactic Cannulation Of The Foramen Ovale For Ablative Treatment Of Trigeminal Neuralgia

Cited by 48 publications

References 36 publications

Percutaneous Balloon Compression of Trigeminal Ganglion for the Treatment of Idiopathic Trigeminal Neuralgia : Experience in 50 Patients

Percutaneous Balloon Compression of Trigeminal Ganglion for the Treatment of Idiopathic Trigeminal Neuralgia : Experience in 50 Patients

Image guided surgery of the lateral skull base: Testing a new dental splint registration device

Accuracy and diagnostic yield of CT-guided stereotactic liver biopsy of primary and secondary liver tumors

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