scholarly journals Trigeminal Neuralgia: Role and Neurosurgical Indications of Peripheral Alcohol Injections, Controlled Radiofrequency Thermocoagulation, Gasserian Ganglion Compression with Balloon and Microvascular Decompression in Posterior Cranial Fossa. Experience in 437 Patients

2011 ◽  
Vol 02 (01) ◽  
Author(s):  
Mario Francesco Fraioli ◽  
Mario Lecce ◽  
Damiano Lisciani ◽  
Bernardo Fraioli
Keyword(s):  
Trigeminal Neuralgia ◽  
Microvascular Decompression ◽  
Posterior Cranial Fossa ◽  
Gasserian Ganglion ◽  
Radiofrequency Thermocoagulation ◽  
Cranial Fossa

Flat Posterior Cranial Fossa Affects Outcomes of Microvascular Decompression for Trigeminal Neuralgia

2018 ◽  
Vol 111 ◽  
pp. e519-e526 ◽  
Author(s):  
Toshiki Fukuoka ◽  
Yusuke Nishimura ◽  
Masahito Hara ◽  
Kei Nomura ◽  
Hiroshi Ryu ◽  
...  
Keyword(s):  
Trigeminal Neuralgia ◽  
Microvascular Decompression ◽  
Posterior Cranial Fossa ◽  
Cranial Fossa

Novel Techniques for Trigeminal Neuralgia Including Trigeminal Neurostimulators

2018 ◽  
pp. 118-138
Author(s):  
Arvin R. Wali ◽  
Christian Lopez ◽  
Peter Abraham ◽  
Michael G. Brandel ◽  
David R. Santiago-Dieppa ◽  
...  
Keyword(s):  
Trigeminal Neuralgia ◽  
Facial Nerve ◽  
Patient Selection ◽  
Microvascular Decompression ◽  
Published Data ◽  
Gasserian Ganglion ◽  
Therapeutic Modalities ◽  
Trigeminal Nerve Stimulation ◽  
Surgical Options ◽  
Novel Therapeutic

Several innovative surgical options for the management of trigeminal neuralgia have emerged over the past 40 years. In addition to microvascular decompression, other techniques have been introduced for the treatment of trigeminal neuralgia and facial nerve pain. This chapter describes the following novel therapeutic modalities: endoscopic microvascular decompression, radiosurgery, radiofrequency, thermocoagulation, glycerol rhizotomoy, balloon compression, Gasserian ganglion stimulation, and subcutaneous trigeminal nerve stimulation. For each of these techniques, this chapter provides a description of the procedure, criteria for patient selection, and discusses published data regarding patient outcomes.

Unconventional Facial Entry Points Confirmed Using a 3D CT Reconstruction–Guided Stereotactic Approach to Radiofrequency Thermocoagulation for the Treatment of Trigeminal Neuralgia: A Series of Case Reports

Pain Medicine ◽  
2018 ◽  
Vol 20 (8) ◽  
pp. 1551-1558 ◽  
Author(s):  
Zhigang Guo ◽  
Zhijia Wang ◽  
Kai Li ◽  
Chao Du ◽  
Xingli Zhao ◽  
...  
Keyword(s):  
Trigeminal Neuralgia ◽  
Anatomical Variation ◽  
Preoperative Imaging ◽  
Gasserian Ganglion ◽  
Ct Reconstruction ◽  
Foramen Ovale ◽  
Radiofrequency Thermocoagulation ◽  
Patient Reported ◽  
Entry Points

Abstract Objectives Patients with trigeminal neuralgia who are refractory to medical therapy may choose to undergo Gasserian ganglion percutaneous radiofrequency thermocoagulation. However, in cases where the foramen ovale is difficult to access due to various anatomical anomalies, the typical estimation of the facial entry point is suboptimal. Methods Three-dimensional computed tomography reconstruction imaging performed before surgery revealed anatomical variations in each of the four adult patient cases that made it more difficult to successfully access the foramen ovale (FO) for percutaneous radiofrequency thermocoagulation. Using measurements collected from preoperative imaging that showed each specific anatomical variation in the FO, researchers marked alternate facial entry points that would allow successful probe placement into the FO and recorded the arc angle data in the stereotactic instrument. Results Patients were evaluated during follow-up visits ranging from seven to 26 months after surgery and asked to rate postoperative pain using a visual analog scale. These scores decreased from 10 to 3 in all four patients by the third day after the procedure. There were no permanent complications or morbidities from the surgery. One patient experienced mild facial numbness; however, this side effect subsided within three months after surgery. During the follow-up period, no patient reported pain recurrence. Conclusions The expectation for clinicians approaching trigeminal nerve block using a peri-oral approach should be to expect a great degree of potential variability in terms of both distances from the corner of the mouth and needle angle taken to successfully navigate the anatomy and access the foramen ovale.

Chronic emesis due to compression of the area postrema by the posterior inferior cerebellar artery: resolution following microvascular decompression

2010 ◽  
Vol 6 (6) ◽  
pp. 583-585 ◽  
Author(s):  
Martin M. Mortazavi ◽  
R. Shane Tubbs ◽  
Daniel Harmon ◽  
W. Jerry Oakes
Keyword(s):  
Microvascular Decompression ◽  
Area Postrema ◽  
Posterior Inferior Cerebellar Artery ◽  
Posterior Cranial Fossa ◽  
Significant Weight Loss ◽  
Surgical Exploration ◽  
Cerebellar Artery ◽  
Cranial Fossa ◽  
Jejunostomy Feeding

Chronic emesis may result from a variety of causes. To the authors' knowledge, compression of the area postrema by regional vessels resulting in chronic emesis has not been reported. The authors report on a child who presented with chronic medically intractable emesis and significant weight loss requiring jejunostomy feeding. Surgical exploration of the posterior cranial fossa found unilateral compression of the area postrema by the posterior inferior cerebellar artery. Microvascular decompression resulted in postoperative and long-term resolution of the patient's emesis. Although apparently very rare, irritation of the area postrema from the posterior inferior cerebellar artery with resultant medically intractable chronic emesis may occur. Therefore, the clinician should be aware of this potential etiology when dealing with such patients.

Flat-shaped posterior cranial fossa was associated with poor outcomes of microvascular decompression for primary hemifacial spasm

2020 ◽  
Vol 162 (11) ◽  
pp. 2801-2809
Author(s):  
Kai Zhao ◽  
Junwen Wang ◽  
Weihua Liu ◽  
Jiaxuan Zhang ◽  
Kai Shu ◽  
...  
Keyword(s):  
Hemifacial Spasm ◽  
Microvascular Decompression ◽  
Posterior Cranial Fossa ◽  
Cranial Fossa ◽  
Poor Outcomes

scholarly journals Radiofrequency Thermocoagulation Through Foramen Rotundum Versus Foramen Ovale for the Treatment of V2 Trigeminal Neuralgia

2019 ◽  
Vol 6 (22;6) ◽  
pp. E609-E614
Author(s):  
Cong-yang Yan
Keyword(s):  
Trigeminal Neuralgia ◽  
Facial Pain ◽  
Operation Time ◽  
Controlled Clinical Trial ◽  
Gasserian Ganglion ◽  
Internal Opening ◽  
Foramen Ovale ◽  
Maxillary Nerve ◽  
Radiofrequency Thermocoagulation ◽  
Foramen Rotundum

Background: Percutaneous radiofrequency thermocoagulation through the foramen rotundum (FR) is a new approach for the treatment of V2 trigeminal neuralgia (TN). Objectives: This study aimed to compare the efficacy and safety of the FR approach with that of the foramen ovale (FO) approach. Study Design: Nonrandomized controlled clinical trial. Setting: The study was conducted at Huaian Hospital of Huaian City, Huaian, China. Methods: From July 2014 to December 2016, 80 consecutive patients with V2 TN were prospectively assigned into the FO group (n = 40) or the FR group (n = 40). All radiofrequency thermocoagulation procedures were performed under the guidance of digital subtraction angiography (DSA). Patients in the FO group were treated with Gasserian ganglion ablation through the Hartel approach. Patients in the FR group received ablation of the maxillary nerve at the internal opening of the FR. Facial pain was evaluated using the Visual Analog Scale preoperatively and postoperatively at 1 week, 6 months, and 1 year. Results: All surgical procedures were successfully completed using DSA guidance. The FR group had no facial pain at postoperative 1 week, 6 months, and 1 year. The facial fain was not relieved in 4 patients of the FO group. They were treated with radiofrequency thermocoagulation of the maxillary nerve through the FR and maintained painless at postoperative 1 week, 6 months, and 1 year. At postoperative 1 year, another 3 patients relapsed in the FO group. The incidences of facial numbness and swelling did not differ significantly between the 2 groups (all P > 0.05). There was no postoperative corneal involvement or masticatory weakness in the FR group. However, corneal involvement and masticatory weakness occurred postoperatively in 22 (55%) patients and 31 (77.5%) patients in the FO group. The FR group had significantly shorter operation time than the FO group (19.3 ± 5.9 vs. 32.7 ± 8.7 minutes; P < 0.05). Limitations: We were unable to avoid the V1 and V3 branches, despite multiple adjustments of the needed position in 35 of the 40 patients in this group. Conclusions: For the treatment of V2 TN, thermocoagulation of the maxillary nerve through the FR had better efficacy and fewer complications in comparison with the Gasserian ganglion ablation through the FO

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