Neuronavigation-Specific Parameters for Selective Access of Trigeminal Rootlets in Radiofrequency Lesioning: A...

Area of Science:

• Neurosurgery
• Anatomy
• Medical Technology

Background:

• Radiofrequency lesioning (RFL) is a standard treatment for trigeminal neuralgia.
• Current RFL techniques often lack precise targeting of individual trigeminal rootlets.
• Neuronavigation offers potential for improved accuracy in RFL procedures.

Purpose of the Study:

• To develop and evaluate a neuronavigation-specific morphometric roadmap for selective targeting of trigeminal nerve rootlets.
• To provide neurosurgeons with parameters for precise cannula guidance in RFL.

Main Methods:

• Cadaveric specimens were registered to cranial neuronavigation systems.
• Frontotemporal craniotomies allowed direct visualization of the Gasserian ganglion.
• A neuronavigation-guided cannula was advanced through the foramen ovale to pre-planned targets for V1, V2, and V3.

Main Results:

• Twenty RFL procedures were performed on cadaveric specimens.
• Successful contact with V3, V2, and V1 was achieved in 95%, 90%, and 85% of attempts, respectively.
• Key morphometric data, including distances from entry point to foramen ovale, were recorded.

Conclusions:

• A neuronavigation-specific algorithm enables reliable access to trigeminal nerve V1-3.
• Neuronavigation holds promise for enhancing anatomic selectivity and operative efficiency in RFL.
• Further investigation is warranted to explore neuronavigation's role in improving RFL patient outcomes.