ABSTRACT
Objective To observe the efficacy of Mimics finite element analysis software in the gasserian ganglion radiofrequency treatment of trigeminal neuralgia. Methods 180 cases with primary trigeminal neuralgia and VAS score ≥8 were randomly divided into 2 groups (n = 90 each): CT group (group C) and Mimics group (group M). The preoperative skull CT image of the foramen of cranial base could be analyzed in group C. The preoperative cranial CT image could be reconstructed and analyzed by Mimics finite element analysis software in group M. The puncturing success rate, complications rate and the outcomes between two groups were recorded. Results The puncturing success rates were 100% in group M and 92% in group C (P 0.05) between them. Conclusions The Mimics finite element analysis software could improve the success rate of basicranial foramen ovale puncture and reduce the occurrence rate of puncture complications. Therefore , it could be safely applied to the treatment of primary trigeminal neuralgia by gasserian ganglion radio frequency.
ABSTRACT
Objective To evaluate the efficacy of neuronavigation-guided selective percutaneous radiofrequency aiming at the target point semilunar ganglion in the treatment of trigeminal neuralgia.Methods One hundred and forty-seven patients with primary trigeminal neuralgia of both sexes,aged 32-99 yr,with VAS score ≥ 8,were randomly divided into 2 groups:C-arm group (group C,n =72) and neuronavigation group (group N,n =72).Hartel anterior puncture was used and the C-arm guided puncture was performed at the target point foramen ovale in group C.In group N,three-dimensional reconstruction was made after the skull MRI images were transmired to the navigational system of StealthStation,and then the puncture path and point were designed after the target in the trigeminal ganglion was determined.The successful puncture and puncture-and radiofrequency-related complications were also recorded.The VAS scores were recorded at 1 and 7 days and 1,6,12 and 24 months after operation and the analgesic efficacy was evaluated.The therapeutic effect was evaluated by using Barrow Neurological Institute scoring system at 1 and 24 months after operation.Results No puncture-related side effects,damage to the oculomotor nerve or tinnitus developed in group N.The success rate of puncture at first attempt and the effective analgesia rate at different time points after operation were significantly higher,and the treatment effect was better in group N than in group C (P ＜ 0.05).There was no significant difference in the time for location of the nerve and incidence of facial numbness between the two groups (P ＞ 0.05).Conclusion Neuronavigation-guided selective percutaneous radiofrequency aiming at the target point semilunar ganglion in the treatment of trigeminal neuralgia provides a better efficacy,and a lower recurrence rate and a higher probability of successful puncture,with fewer complications.