Department of Anesthesiology, Gunma University Hospital, 3-39-15 Showa-machi, Maebashi 371-8511, Japan.
Anesth Analg. 2010 Sep;111(3):763-7. doi: 10.1213/ANE.0b013e3181e5e8d6. Epub 2010 Aug 4.
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.
我们提出了一种新的经皮射频下颌神经干切断术方法，用于缓解下颌区域的疼痛，该方法在高速实时计算机断层扫描 (CT) 透视引导下进行。11 名特发性三叉神经痛患者（13 例手术）接受了该手术。CT 透视同时提供了 1 个透视视野中的 3 个层面（1 毫米间隔系列，头尾向），从而实现了准确的进针。所有患者的三叉神经痛均得到改善，无严重并发症。疼痛强度的平均数字评定量表评分（+或-标准差）从 6.5（+或-1.8，治疗前）降至 1.8（+或-1.7，治疗后 1 个月），再降至 0.9（+或-1.0，治疗后 3 个月）。我们的有限病例系列表明，新的 CT 透视引导具有潜在优势，但这些发现有待随机对照试验和大病例系列的证实。
