Application of 3D printing navigational template in puncturing of foramen rotundum for radiofrequency thermocoagulation to treat primary trigeminal neuralgia (V2) / 临床麻醉学杂志

ABSTRACT

Objective To explore the effectiveness and precision of 3D printing navigational template in puncturing of foramen rotundum for radiofrequency thermocoagulation to treat primary trigeminal neuralgia (V2).Methods Forty-three patients (27 males,16 females,aged 45-85 years,ASA grade Ⅰ or Ⅱ) with primary trigeminal neuralgia (V2) were included and randomly divided into experimental group (group A,n=21) and control group (group B,n=22).After taking a CT scan and 3D reconstruction of each patient's skull,puncture simulations were carried out,then the final puncture schemes were decided.In group A,puncture was performed under guidance of navigational template but was conducted empirically in group B.In both groups,3D-CT image and electrical stimulation were used in all the procedures to confirm the location of point of needle before radiofrequency thermocoagulation.The cases of successful puncture in one-time,times of CT scanning,radiant quantity,operation time during the operation in both groups were recorded.Furthermore,NRS scores and complications including hypoesthesia,motor function degeneration,hematoma,absence of corneal reflex,cerebrospinal fluid leakage were recorded after procedure.Results The rate of successful puncture in one-time of group A was superior than that of group B (90.4% vs.22.7%).Compared with group B,CT scan times [(1.1±0.3) times vs.(2.8±1.3) times],radiant quantity [(323.1±108.7) mGy*cm vs.(787.8±355.7) mGy*cm],operation time [(15.3±5.5) min vs.(28.5±6.5) min] in group A were significantly reduced (P<0.05).NRS scores of both two groups were obviously reduced after surgery [group A (3.1±1.7) scores vs.(8.5±0.7) scores;group B (3.1±1.5)scores vs.(8.5±0.7) scores] (P<0.05),but the effectiveness in group A was not superior than group B.No serious complications occurred in all patients.Conclusion On the basis of sufficient preoperative planning of puncture approach,3D printing template can significantly enhance the effectiveness and precision of puncture of foramen rotundum,improving the efficiency and quality of radiofrequency treatment of primary trigeminal neuralgia (V2).