• Chao Du, Zhijia Wang, Yufei Gao, Kai Li, Zhengming Wang, and Yu Tian.
• Department of Neurosurgery, The Third Hospital & China-Japan Union Hospital of Jilin University, Changchun, Jilin, China.
• Pain Pract. 2021 Jun 1; 21 (5): 588-593.

BackgroundIn a minority of cases, 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 a single puncture in the presence of two or more anatomical variations.ObjectivesTo 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.MethodsDuring operation of a unique facial entry point's trigeminal neuralgia patient, make one plane which identified by a three-dimensional (3D) coordinates of the FO target and arc angle value on stereotactic frame, make this plane intersected with another plane which determined by the 3D CT-reconstruction's facial entry point data on a ruler, so as to elucidate the appropriate trajectory. The authors coined the approach "Air-to-air meeting" method.ResultsWe completed the radiofrequency thermocoagulation (RFT) with a single puncture to successfully target the FO according to 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.ConclusionsTo 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.© 2020 World Institute of Pain.

9 keywords...

hide…