A new guidance device facilitates percutaneous puncture of the foramen ovale in human cadavers.
OBJECTIVE
Trigeminal neuralgia is the most common neurological cause for facial pain. Contemporary interventional treatment relies on surgical microvascular decompression or, alternatively, percutaneous interventions targeting the semilunar ganglion via the foramen ovale. For the latter approach, only free-hand punctures using fluoroscopy devices have been reported. Therefore, the present study aimed to evaluate a new fluoroscopy-based guidance device for transforaminal puncture.


METHODS
Two experienced examiners punctured the foramen ovale bilaterally free-hand, and using a guidance device in human cadavers (n = 9). The number of attempts for puncture was recorded. A new attempt was counted each time the needle had to be retracted for redirection.


RESULTS
As compared to the free-hand puncture of the foramen ovale (4.44 +/- 2.79), the new guidance device significantly reduced the number of trials needed (1.37 +/- 0.69).


CONCLUSIONS
The employment of a guidance device facilitated percutaneous transforaminal puncture and resulted in a significantly decreased number of puncture attempts as compared to free-hand techniques in human cadavers.
Hinteregger
Martin
M
Department of Anesthesiology, Medical University of Innsbruck, Anichstr. 35, 6020 Innsbruck, Austria.
Zschiegner
Fritz
F
Lirk
Philipp
P
Ladner
Eugen
E
Goeschl
Albert
A
Gaber
Othmar
O
Moser
Patrizia
P
Lorenz
Ingo
I
Kolbitsch
Christian
C
D002102:Cadaver; D006328:Cardiac Catheterization / Q000295:instrumentation* / Q000379:methods; D004867:Equipment Design / Q000379:methods; D005471:Fluoroscopy / Q000379:methods; D006346:Heart Septum / Q000601:surgery*; D006801:Humans; D011677:Punctures / Q000295:instrumentation*; D018709:Statistics, Nonparametric; D012668:Trigeminal Ganglion