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Αλέξανδρος Γ. Σφακιανάκης

Sunday, December 13, 2020

Air‐to‐Air Meeting Technique in Radiofrequency Thermocoagulation of Trigeminal Neuralgia: A Case Report

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Abstract

Background

In a minority of cases with foramen ovales (FOs) are difficult to access due to single confounding anatomical variations. However, there is no method reported where the FO has been successfully targeted via single puncture in the presence of two or more anatomical variations.

Objectives

To observe the effect of a new stereotactic bidirectional approach guiding technique utilized in a patient who harbored a particularly difficult‐to‐access FO due to multiple anatomical variations.

Methods

During operation of a unique facial entry point's trigeminal neuralgia patient, make a stereotactic frame plane which identified by a three‐dimensional (3D) coordinates of the FO target and arc angle value, intersected with a ruler plane which determined through the 3D CT‐reconstruction's facial entry point data, to elucidate the appropriate trajectory. The authors coined the approach "Air‐to‐air meeting" method.

Results

We completed the RFT with a single puncture to successfully target the FO per the preoperative plan confirmed by C‐arm radiography. Postoperative pain scores using a visual analog scale decreased from 10 to 3 by the first day after the procedure. There were no permanent complications or morbidity from the surgery.

Conclusions

To the authors' knowledge, this is the first report describing a unique facial entry point determined by this technique for the treatment of a patient with trigeminal neuralgia.

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