title: Foramen ovale cannulation guided by intra-operative computed tomography with integrated neuronavigation for the treatment of trigeminal neuralgia.
abstract: BACKGROUND
  Radiofrequency rhizotomy of the Gasserian ganglion for the treatment of trigeminal neuralgia via percutaneous cannulation of the foramen ovale is facilitated by various localization modalities. In our preliminary study, we described the feasibility of computed tomography (CT) using an integrated neuronavigation system to cannulate the foramen ovale.
  
  
  METHODS
  Analysis was performed on 42 consecutive patients who underwent cannulation of the foramen ovale for radiofrequency trigeminal rhizotomy guided by CT using an integrated neuronavigation system. The reproducibility and safety of the neuronavigation-guided procedure were evaluated.
  
  
  RESULTS
  Overall, the average dimension of the foramen ovale was 7.1 (1.5)  ×  4.7 (1.1) mm, and it was successfully cannulated by neuronavigation guidance in 31 (73.8%) patients with a mean cannulation time of 3.1 (0.7) min and an overall procedure time of 68.2 (16.4) min. The remaining 11 (26.2%) patients required subsequent CT guidance for successful puncture of the foramen ovale.
  
  
  CONCLUSIONS
  These data demonstrate that neuronavigation-guided cannulation of the foramen ovale can be executed both quickly and safely on an outpatient basis. Additionally, the use of CT with integrated neuronavigation technology provides superior visual-spatial information compared to conventional fluoroscopy, the process of CT scanning, object planning, and neuronavigation-guided intervention can be completed in the same locale, and its application is easy to master and has the potential to enhance procedure tolerability of awake patients.
authors.affiliation: Department of Neurosurgery, Chang Gung Memorial Hospital, 6 Sec West, Chia Pu Rd, Pu Tz City, Chia-Yi, Taiwan.
authors.forename: Martin Hsiu-Chu
authors.initials: MH
authors.lastname: Lin
authors.forename: Ming-Hsueh
authors.initials: MH
authors.lastname: Lee
authors.forename: Ting-Chung
authors.initials: TC
authors.lastname: Wang
authors.forename: Yu-Kai
authors.initials: YK
authors.lastname: Cheng
authors.forename: Chen-Hsing
authors.initials: CH
authors.lastname: Su
authors.forename: Chia-Mao
authors.initials: CM
authors.lastname: Chang
authors.forename: Jen-Tsung
authors.initials: JT
authors.lastname: Yang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017115:Catheter Ablation / Q000295:instrumentation / Q000379:methods*; D005260:Female; D054085:Foramen Ovale / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D038361:Neuronavigation / Q000295:instrumentation / Q000379:methods*; D010865:Pilot Projects; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D019051:Rhizotomy / Q000295:instrumentation / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome; D014277:Trigeminal Neuralgia / Q000209:etiology / Q000601:surgery*; D055815:Young Adult