Percutaneous balloon compression technique using intraoperative contrasted DynaCT for the treatment of refractory trigeminal neuralgia: initial experience.
Publication/Presentation Date
4-1-2022
Abstract
OBJECTIVE: Percutaneous balloon compression (BC) is a well-established technique that can provide immediate relief to patients suffering from trigeminal neuralgia (TN). The general procedure of BC uses fluoroscopy imaging to guide the needle through the foramen ovale (FO). The aim of this study was to describe our experience with a novel technique using intraoperative contrast-enhanced DynaCT as an adjunct for more accurate and safer guidance of the needle to the FO.
METHODS: In this study, DynaCT was used to perform BC in 20 TN cases. The three-dimensional path of the needle was pre-planned using DynaCT obtained during the administration of IV contrast. The FO was accessed in a single pass along the path pre-determined from the DynaCT images, avoiding any major arteries and veins. DynaCT was also used for confirmation of the final position of the needle prior to insertion of the balloon as well as for confirmation of the position of the balloon after inflation.
RESULTS: Intravenous contrast-enhanced DynaCT-guided percutaneous BC allowed precise advancement and positioning of the needle within the FO. It facilitated cannulation of the FO along a pre-determined path that avoided any major vascular structures. Clinical outcomes were excellent-all patients had a quick postoperative recovery, and there were no complications.
CONCLUSIONS: The advantages of the contrast-enhanced DynaCT-guided technique include a single precise needle pass and avoidance of vessel injury. Precise placement of the balloon into different aspects of the FO can target trigeminal branches more selectively and allow for a better outcome.
Volume
45
Issue
2
First Page
1393
Last Page
1399
ISSN
1437-2320
Published In/Presented At
Jain, A., Ibrahim, B., Ali, A., Muhsen, B. A., Najera, E., Adada, B., Borghei-Razavi, H., & Obrzut, M. (2022). Percutaneous balloon compression technique using intraoperative contrasted DynaCT for the treatment of refractory trigeminal neuralgia: initial experience. Neurosurgical review, 45(2), 1393–1399. https://doi.org/10.1007/s10143-021-01649-4
Disciplines
Medicine and Health Sciences
PubMedID
34599700
Department(s)
Department of Surgery, Department of Surgery Residents, Fellows and Residents
Document Type
Article