Technical communication: percutaneous radiofrequency mandibular nerve rhizotomy guided by high-speed real-time computed tomography fluoroscopy

Anesth Analg. 2010 Sep;111(3):763-7. doi: 10.1213/ANE.0b013e3181e5e8d6. Epub 2010 Aug 4.

Abstract

We present a new method of percutaneous radiofrequency mandibular nerve rhizotomy for pain relief in the mandibular region, in which needle placement is guided by high-speed real-time computed tomography (CT) fluoroscopy. Eleven patients (13 procedures) with idiopathic trigeminal neuralgia underwent the procedure. CT fluoroscopy simultaneously provided 3 slices (1-mm interval series, craniocaudally) in 1 fluoroscopic view, allowing for accurate needle placement. Trigeminal neuralgia improved in all patients without severe complications. The mean numerical rating scales of pain intensity (+ or - sd) decreased from 6.5 (+ or - 1.8, pretreatment) to 1.8 (+ or - 1.7, 1 month after treatment) and to 0.9 (+ or - 1.0, 3 months after treatment). Our limited-case series suggests potential advantages for the new CT fluoroscopy guidance, but these findings await confirmation from randomized controlled trials and large-case series.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anesthesia
  • Computer Systems
  • Female
  • Fluoroscopy
  • Humans
  • Male
  • Mandibular Nerve / diagnostic imaging*
  • Mandibular Nerve / surgery*
  • Middle Aged
  • Postoperative Complications / epidemiology
  • Radiosurgery / methods*
  • Retrospective Studies
  • Rhizotomy / methods*
  • Surgery, Computer-Assisted / methods*
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Trigeminal Neuralgia / surgery