应用卵圆孔定位仪治疗三叉神经痛

Application of foramen oval localization instrument for trigeminal neuralgia

目的总结卵圆孔定位仪在选择性经皮温控射频热凝治疗三叉神经痛的应用方法和技巧。方法对三叉神经第Ⅱ、Ⅲ支疼痛者或第Ⅰ、Ⅱ、Ⅲ支同时疼痛者应用Hartel前入路半月神经节射频热凝治疗,其中260例患者应用三叉神经卵圆孔定位仪辅助定位,对39例患者术中应用X线或三维CT进行卵圆孔靶点验证。结果所有病例穿刺成功。术后即刻疗效:优良206例,良好42例,无疗效12例,总有效率95.4%,无严重并发症发生。结论卵圆孔定位仪可用于射频热凝治疗三叉神经痛的辅助定位,可以提高穿刺的成功率和安全性。

Objective To investigation the design principle, structure of trigeminal foramen ovale localization instrument （FOLI）, summarize its clinic application and technique in selective pereutaneous radiofrequency trigeminal rhizotomy （RFTR）. Methods RFTR with Hartel＇s anterior approach of foramen ovale was performed on 260 cases of V2,3 or V1-3 trigeminal neuralgia aided with FOLI. Validation of target with X-ray and 3D-CT for foramen ovale locations were performed in 39 cases so that the direction and position could be defined for trigeminal neuralgia. Result The foramen ovale was successfully cannulated aided at FOLI in 260 patients, which indicated clinical localization accuracies better than free-hand. Excellent rates of pain alleviation can be seen in 206 cases, good in 42 cases and inefficacy in 12 cases. The total effective rate was 95. 4%. Conclusion FOLI is an effective way for selective percutaneous radiofrequency thermocoagulation of trigeminal neuralgia. The presented data suggest that FOLI raise the successful rate of puncture, enhance patient security and can be regarded as adjuvant localization instrument.