Application of stereotactic surgical planning system in foramen ovale puncture for the treatment of trigeminal neuralgia

Abstract

Objective To investigate the practical application value of stereotactic surgical planning system in the foramen ovale puncture for the treatment of idiopathic trigeminal neuralgia. Methods A total of 112 patients with trigeminal neuralgia admitted at the Department of Neurosurgery, the Second Hospital, Shandong University from October 2008 to March 2013 were enrolled. Using stereotactic techniques to complete the radiofrequency treatment of trigeminal neuralgia after foramen ovale puncture of gasserian ganglion. Different from the traditional mounting of the stereotactic frame, this study used reversed mounting frame. The simulation puncture was conducted after the CT scan dicom data were inputted into the stereotactic surgical planning system. The target coordinates, percutaneous puncture point coordinates, and puncture paths were ultimately determined. Results Using the above methods, 112 patients completed foramen ovale punctures. Twenty-five puncture paths were corrected by the stereotactic surgical planning system before procedure (the correction rate was 22.3%). The one-time success rate of foramen ovale puncture was 100% after setting the paths. No serious complications occurred, such as internal carotid artery injury and bleeding, diplopia, and keratitis. The immediate effective rate was 100%, one-year effective rate was 95.5%%, and two-year effective rate was 90.2%. Conclusion Preoperative setting puncture paths using the stereotactic surgical planning system for the treatment of trigeminal neuralgia is accurate, safe, and effective. Key words: Trigeminal neuralgia; Foramen ovale; Punctures; Stereotaxic techniques; Neuronavigation