Table of Contents
ISRN Neurology
Volume 2014 (2014), Article ID 630418, 4 pages
http://dx.doi.org/10.1155/2014/630418
Clinical Study

Minimizing Technical Failure of Percutaneous Balloon Compression for Trigeminal Neuralgia Using Neuronavigation

1Functional Neurosurgery Unit, Department of Neurosurgery, Faculty of Medicine, University of Patras, 26500 Patras, Greece
2Department of Neurology, Faculty of Medicine, University of Patras, 26500 Patras, Greece

Received 9 January 2014; Accepted 23 February 2014; Published 9 March 2014

Academic Editors: W. Lüdemann and D. Mathieu

Copyright © 2014 Miltiadis Georgiopoulos et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. Percutaneous balloon compression (PBC) is an effective and safe management for medically refractory trigeminal neuralgia; however, technical failure to cannulate the foramen ovale (FO) using only fluoroscopy is a significant problem in some cases. In this paper, we suggest the use of intraoperative navigation, in cases of reoperation due to prior technical failure to cannulate the FO under fluoroscopy. Methods. A total of 174 patients underwent PBC for TN since 2003. In 9 cases the penetration of the FO was not accomplished. Five of those patients were reoperated on for PBC using navigation from March 2012 to September 2012. Surgical technique: preoperatively, a head Computed Tomography (CT) scan is performed and the acquired images are imported into the navigation system. Intraoperatively, a small reference frame is strapped firmly to the patient’s forehead, the CT images are registered, and cannulation is performed under the guidance of the navigation system. Results. In all patients, the operation overall was completed successfully. Moreover, all patients reported complete pain relief immediately postoperatively and no complications were recorded overall. Conclusions. We suggest the use of neuronavigation in cases of technical failure of PBC. That technique involves technology with significant advantages helping the successful cannulation of the FO and seems more efficient and safer.