Review

Percutaneous Minimally Invasive Treatment for the Trigeminal Neuralgia: A Review

Xiang-Fei Guo , Jun Ma
Department of Anesthesiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
J Anesth Perioper Med 2015; 2(3): 167- 174 . Published on May 1, 2015 . doi:10.24015/JAPM.2015.0023
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Abstract

Aim of review: The objective of this review is to evaluate the effect of percutaneous minimally invasive treatment for the trigeminal neuralgia (TN).

Method: We systematically searched for clinical studies on the TN. We searched the MEDLINE (PubMed) and EMBASE database, using the free text terms: minimally invasive treatment, TN and combination of these. Date of last electronic search was 30 December 2012.

Recent findings: From the available evidence, we can concluded that:1) Percutaneous glycerol gangliolysis is very effective and applicable to a wide variety of patients with TN. The presence of cerebrospinal fluid (CSF) outflow during puncture predicts better immediate and long-term outcomes; 2) It may be quite obvious that the high-speed real-time CT fluoroscopic method enables better imaging compared to X-ray fluoroscopy; 3) Computed tomography (CT) images are by far superior, when combined with neuronavigation, which allows trajectory visualization in three dimensions and multiple planes at the surgeon's choosing, and use of real-time annulations. Three dimensional (3D)-CT and electrophysiology Gasser's ganglion locations can raise the success rate of puncture, enhance the safety and reduce the incidence of complication, showing high academic value and its promising future; 4) Balloon Compression causes only a mild sensory loss with immediate pain relief in practically all patients; 5) Ultrasound-guided technique for the blockade of trigeminal nerve peripheral branches is very rational.

Summary: For both treatment methods, the fused CT and magnetic resonance imaging (MRI) scans are used for improved treatment planning in the treatment for the TN. While the MRI scans provides better details on the anatomical situation, CT scans are required for dissymmetric assessment. In the future, other imaging methods like spectroscopy and evoked-potential imaging will become available to better shape the target volume and spare critical normal tissue structures.

 

 

Citation: Xiang-Fei Guo, Jun Ma. Percutaneous minimally invasive treatment for the trigeminal neuralgia: a review. J Anesth Perioper Med 2015; 2: 167-74. doi: 10.24015/JAPM.2015.0023

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