Role of interventional radiology in pudendal neuralgia: a description of techniques and review of the literature.

PURPOSE: The authors sought to evaluate indications, technical feasibility and clinical efficacy of computed tomography (CT)-guided pudendal nerve infiltration in patients with chronic anoperineal pain by reviewing the role of the CT technique in their personal experience and in the recent interventional literature. MATERIALS AND METHODS: Twenty-eight women, mean age 50 years, and with a diagnosis of pudendal neuralgia on the basis of clinical and electromyographic criteria were enrolled in the study. CT-guided pudendal nerve injections were performed during three consecutive sessions held 2 weeks apart. In each session, patients received two percutaneous injections: one in the ischial spine, and the other in the pudendal (Alcock's) canal. RESULTS: One patient dropped out of the study after the first session. At clinical assessment, 24h h after treatment, 21/27 patients reported significant pain relief. At follow-up at 3, 6, 9 and 12 months, 24/27 patients reported a>or=20% improvement in the Quality of Life (QOL) index. CONCLUSIONS: In pudendal nerve entrapment, CT-guided perineural injection in the anatomical sites of nerve impingement is a safe and reproducible treatment with a clinical efficacy of 92% at 12 months.

Bennett movement of mandible: a comparison between traditional methods and a 64-slices CT scanner.

OBJECTIVE: compare the values of the Bennett angle measured by an average value articulator with the ones measured by a 64 slices Computed Tomography (CT). METHODS: we have studied a patient aged 72. Maxillary and mandibular impressions were obtained from the patient and placed on the average value articulator using wax-ups and a facial arch in order to perform the Bennett angle measurations by such device. CT measurements were carried out using templates in order to block the Patient in the correct mandibular position. RESULTS: our study has demonstrated that the measurements of the Bennett angle obtained with the average value articulator are consistent with the ones obtained with the 64 slices CT. CONCLUSIONS: CT scanning is a useful method, alternative to conventional procedures, as the average value articulator for Bennett angle measurements, and it could become an important diagnostic tool in the gnathological and rehabilitative area.