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. 2024 Jun 4;166(1):247.
doi: 10.1007/s00701-024-06147-2.

Neuronavigated percutaneous gasserian radiofrequency thermorhizotomy for trigeminal neuralgia: how I do it

Michele Rizzi  1 , Nicolò Castelli  2 , Donato Martino  3 , Vittoria Nazzi  1
Affiliations

Neuronavigated percutaneous gasserian radiofrequency thermorhizotomy for trigeminal neuralgia: how I do it

Michele Rizzi et al. Acta Neurochir (Wien). .

Abstract

Background: Radiofrequency thermorhizotomy (TRZ) is an established treatment for trigeminal neuralgia (TN). TRZ can result risky and painful in a consistent subset of patients, due to the need to perform multiple trajectories, before a successful foramen ovale cannulation. Moreover, intraoperative x-rays are required.

Method: TRZ has been performed by using a neuronavigated stylet, before trajectory planning on a dedicated workstation.

Conclusion: Navigated-TRZ (N-TRZ) meets the expectations of a safer and more tolerable procedure due to the use of a single trajectory, avoiding critical structures. Moreover, N-TRZ is x-ray free. Efficacy outcomes are similar to those reported in literature.

Keywords: Foramen ovale; Gasser's ganglion; Magnetic neuronavigation; Pain; Percutaneous; Radiofrequency; Thermorhizotomy; Trigeminal ganglion; Trigeminal nerve; Trigeminal neuralgia.

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