A stereotactic frame for trigeminal ganglionectomy

Area of Science:

• Neurosurgery
• Pain Management
• Medical Device Technology

Background:

• Trigeminal neuralgia is a debilitating condition characterized by severe facial pain.
• Current treatments for trigeminal neuralgia include medication, microvascular decompression, and ablative procedures.
• Percutaneous procedures offer a less invasive option for managing trigeminal neuralgia.

Purpose of the Study:

• To introduce and describe a novel stereotactic frame (Radionics) for percutaneous electrocoagulation of the trigeminal ganglion.
• To highlight the frame's capability to selectively target specific trigeminal nerve rootlets.
• To detail the surgical approaches for accessing the foramen ovale using this device.

Main Methods:

• Utilized a specialized stereotactic frame (Radionics) for precise electrode placement.
• Performed percutaneous electrocoagulation targeting the trigeminal ganglion.
• Employed selective targeting of the first, second, or third rootlet based on pain distribution.
• Achieved foramen ovale penetration via jugal or submaxillary approaches.
• Guided procedures with fluoroscopic imaging.

Main Results:

• The Radionics frame facilitated accurate percutaneous electrocoagulation of the trigeminal ganglion.
• Selective targeting of individual rootlets was achievable, correlating with pain territories.
• Both jugal and submaxillary approaches allowed successful foramen ovale penetration.
• Fluoroscopic guidance ensured procedural safety and accuracy.

Conclusions:

• The Radionics stereotactic frame provides a precise and adaptable tool for percutaneous electrocoagulation of the trigeminal ganglion.
• This method allows for selective treatment of specific trigeminal nerve branches, potentially improving efficacy and reducing side effects.
• The described surgical approaches are effective for accessing the target area, offering viable options for trigeminal neuralgia management.