Percutaneous controlled radiofrequency trigeminal rhizotomy
for the treatment of idiopathic trigeminal neuralgia: 25-year ex-perience with 1,600 patients.
In this review, RF trigeminal rhizotomy is still an invaluable technique that has provided pain relief for many patients with trigeminal neuralgia and it may be prudent to even consider performing PRF prior to RF for a sole purpose of avoiding disturbing sensory paresthesia and masseter paralysis of ablative neurosurgical techniques for the treatment of trigeminal neuralgia.16 However, Erdine et al, demonstrated in a double-blinded trial that PRF was remarkably less efficacious that conventional RF17.
Percutaneous controlled radio frequency trigeminal rhizotomy for the treatment of idiopathic trigeminal neuralgia: 25-year experience with 1,600 patients.
Incidence, morphology and morphometry of foramen Vesalius: complimentary study for a safer planning and execution of trigeminal rhizotomy
Honey, "Percutaneous radio-frequency trigeminal rhizotomy in a patient with an implanted cardiac pacemaker," Anesthesia and Analgesia, vol.
Berk, "Percutaneous controlled radiofrequency trigeminal rhizotomy for the treatment of idiopathic trigeminal neuralgia: 25-year experience with 1600 patients," Neurosurgery, vol.
Incidence morphology and morphometry of the foramen of Vesalius complementary study for a safer planning and execution of the trigeminal rhizotomy
The other case of CAS was reported in patient (79 y, female) undergoing radiofrequency trigeminal rhizotomy for trigeminal neuralgia under monitored anesthesia care .
In cases of trigeminal rhizotomy, either passage of the needle through the foramen ovale or the stimulation of Gasserian ganglion by glycerol or electric current is usually sufficient to evoke TCR and can manifest as severe hypertension, tachycardia, and other ECG changes.
As the FO is regarded as an easily accessible portal to the mandibular division of the trigeminal nerve during percutaneous trigeminal rhizotomy
and neural blockade anesthesia, the proximity of the FS to the FO may render the middle meningeal vessels vulnerable to iatrogenic injury, thereby increasing the risk of extradural hematomas (Shaik et al.; Srimani et al.).
Knowing the anatomic variations of foramen ovale is important because surgical treatment of trigeminal neuralgia is most commonly accomplished by microvascular decompression by percutaneous trigeminal rhizotomy
. (5,6) The accuracy of percutaneous biopsy of cavernous sinus tumors through the foramen ovale is 84%.
Surgical procedures that interrupt the pain pathway offer an option. Invasive management procedures include radiofrequency rhizotomy, cryotherapy, alcohol or nerve glycerol injection, balloon gangliolysis, and percutaneous thermocoagulation.[19,40,42] The surgical treatment of choice is trigeminal rhizotomy
.[14,28,29] The risk of full or partial sensory deficit as a result of trigeminal rhizotomy
must be weighed against the intolerance to the medical management of TN pain.