• Wenchang Guo, Yinzhan Wang, Yihui Du, Haowei Shi, Shanshan Shen, and Tao Qian.
• Department of Neurosurgery, Hebei General Hospital, Shijiazhuang, China.
• World Neurosurg. 2024 Sep 1; 189: 312316312-316.

ObjectiveIntroducing a preoperative image simulation technique to streamline the visualization of the foramen ovale in percutaneous microcompression.MethodsTwenty-five trigeminal neuralgia patients were included in the study. Preoperative cranial computed tomography scans were processed with 3D Slicer software to create simulated fluoroscopic skulls. The angulations required for precise visualization of the foramen ovale were established via simulated anteroposterior imaging. These simulations informed the C-arm's angulations for foramen ovale targeting during surgery.ResultsThe preoperative simulations accurately forecasted skull rotation angulations, aligning closely with intraoperative observations with negligible discrepancies (0-2 degrees). In 17 patients, the foramen ovale was distinctly visible, while in 8 patients, it was partially obscured yet discernible using the simulated angles. Nonvisible of the foramen ovale did not occur. Postoperative pain relief and complications were recorded.ConclusionsBased on our initial findings, the application of preoperative image simulation shows significant referential value in achieving accurate visualization of the foramen ovale in percutaneous microcompression for trigeminal neuralgia.Copyright © 2024 Elsevier Inc. All rights reserved.

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