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首页> 外文期刊>Pain medicine : >CT-guided percutaneous infrazygomatic radiofrequency neurolysis through foramen rotundum to treat V2 trigeminal neuralgia
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CT-guided percutaneous infrazygomatic radiofrequency neurolysis through foramen rotundum to treat V2 trigeminal neuralgia

机译：CT引导下圆形圆孔经皮fra下射频神经溶解治疗V2三叉神经痛

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Objective: Percutaneous radiofrequency thermocoagulation or neurolysis of Gasserian ganglion through foramen ovale (FO) is the classical approach to treat trigeminal neuralgia (TN). However, it has been technically challenging when individual trigeminal sub-branch nerve block is desired through this approach. We have thus developed a novel computed tomograph-guided technique to block the V2 trigeminal nerve through foramen rotundum (FR). With this technique, we have conducted a study of 27 patients with isolated V2 TN. We hypothesize that this new technique will have comparable clinical outcome with the conventional FO approach. Design: Prospective study. Setting: Academic hospitals. Subjects: Twenty-seven patients with isolated classical V2 TN were enrolled and divided into FO group (N=12) and FR group (N=15). Methods: Numeric Rating Scale (NRS) scores for facial pain, at pretreatment, immediate postoperative, postoperative 1 day, and 1, 6, and 12 months were recorded. The primary clinical outcome (successful pain relief with 50% or more reduction in NRS) and secondary adverse clinical outcome (hematoma, facial numbness, masticatory weakness, and corneal involvement) were compared and analyzed. Results: Both groups have good immediate and sustained pain relief. However, when compared with the FO group, the FR group is associated with shorter procedural time (29.2±9.3 vs 45.4±22.13 minutes, P<0.05), has less nonspecific block in V1 and V3 dermatomes, and has fewer adverse outcomes including masticatory weakness (0/15 vs 5/12) and corneal perforation (0/12 vs 1/15). Conclusions: We have developed a novel technique to selectively block the V2 trigeminal nerve at FR. This novel FR approach may be a good alternative to the classical FO approach when an isolated V2 branch block is desired.
机译：目的：经卵圆孔（FO）经皮射频热凝或加塞神经节神经溶解是治疗三叉神经痛（TN）的经典方法。但是，通过此方法需要单个三叉神经支神经下阻滞在技术上具有挑战性。因此，我们开发了一种新颖的计算机断层扫描仪引导技术，以通过圆孔（FR）阻断V2三叉神经。通过这项技术，我们对27例孤立的V2 TN患者进行了研究。我们假设该新技术将具有与传统FO方法相当的临床效果。设计：前瞻性研究。地点：学术医院。受试者：27例孤立的经典V2 TN患者入选，分为FO组（N = 12）和FR组（N = 15）。方法：记录术前，术后即刻，术后1天，1、6和12个月的面部疼痛的数字评分量表（NRS）评分。比较并分析了主要的临床结果（成功缓解疼痛，NRS降低了50％或更多）和次要的不良临床结果（血肿，面部麻木，咀嚼无力和角膜受累）。结果：两组均具有良好的即刻和持续疼痛缓解。但是，与FO组相比，FR组的手术时间更短（29.2±9.3 vs 45.4±22.13分钟，P <0.05），V1和V3皮肤切开术的非特异性阻断更少，包括咀嚼的不良后果更少虚弱（0/15对5/12）和角膜穿孔（0/12对1/15）。结论：我们开发了一种新技术来选择性地阻断FR的V2三叉神经。当需要隔离的V2分支模块时，此新颖的FR方法可能是经典FO方法的很好替代方法。

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