Technical communication: percutaneous radiofrequency mandibular nerve rhizotomy guided by high-speed real-time computed tomography fluoroscopy.
We present a new method of percutaneous radiofrequency mandibular nerve rhizotomy for pain relief in the mandibular region, in which needle placement is guided by high-speed real-time computed tomography (CT) fluoroscopy. Eleven patients (13 procedures) with idiopathic trigeminal neuralgia underwent the procedure. CT fluoroscopy simultaneously provided 3 slices (1-mm interval series, craniocaudally) in 1 fluoroscopic view, allowing for accurate needle placement. Trigeminal neuralgia improved in all patients without severe complications. The mean numerical rating scales of pain intensity (+ or - sd) decreased from 6.5 (+ or - 1.8, pretreatment) to 1.8 (+ or - 1.7, 1 month after treatment) and to 0.9 (+ or - 1.0, 3 months after treatment). Our limited-case series suggests potential advantages for the new CT fluoroscopy guidance, but these findings await confirmation from randomized controlled trials and large-case series.
Koizuka
Shiro
S
Department of Anesthesiology, Gunma University Hospital, 3-39-15 Showa-machi, Maebashi 371-8511, Japan. skoizuka@med.gunma-u.ac.j
Saito
Shigeru
S
Tobe
Masaru
M
Sekimoto
Kenichi
K
Obata
Hideaki
H
Koyama
Yoshinori
Y
D000368:Aged; D000369:Aged, 80 and over; D000758:Anesthesia; D003199:Computer Systems; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008340:Mandibular Nerve / Q000000981:diagnostic imaging* / Q000601:surgery*; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D016634:Radiosurgery / Q000379:methods*; D012189:Retrospective Studies; D019051:Rhizotomy / Q000379:methods*; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014277:Trigeminal Neuralgia / Q000601:surgery