Aydoseli Aydin, Akcakaya Mehmet Osman, Aras Yavuz, Sabanci Pulat Akin, Unal Tugrul Cem, Sencer Altay, Hepgul Kemal, Unal Omer Faruk, Barlas Orhan, Izgi Nail
a Department of Neurosurgery , Istanbul School of Medicine, Istanbul University , Istanbul , Turkey.
Br J Neurosurg. 2015;29(4):552-8. doi: 10.3109/02688697.2015.1019418. Epub 2015 Mar 25.
Percutaneous balloon compression (PBC) has been widely used in the treatment of trigeminal neuralgia. However, this technique has a steep learning curve and significant complications were reported that were related to foramen ovale puncturing. The aim of this study was to evaluate the clinical results of a small patient group who underwent neuronavigation-assisted PBC.
An intraoperative computed tomography (CT) device (CereTom, Neurologica, Danvers, MA/USA) was used to obtain CT scans with 2-mm slice thicknesses. The data were transferred to a neuronavigation system planning station (BrainLab, Feldkirchen, Germany). A soft touch registration system was used for image registration. With the image guidance, a trajectory was defined and the foramen ovale was cannulated using neuronavigation and Hartel's landmarks.
Sixteen procedures were performed on 13 patients (4 female and 9 male) without complications. The total length of the procedure was not more than 57 min in all instances.
We believe that image-guided neuronavigation is useful for neurosurgeons who are at the beginning of their PBC learning curve. It may also be an alternative for particular patients with significant anatomic variations that result in an unsuccessful foramen ovale puncture.
经皮球囊压迫术（PBC）已广泛应用于三叉神经痛的治疗。然而，该技术学习曲线陡峭，且有报道称与卵圆孔穿刺相关的严重并发症。本研究的目的是评估接受神经导航辅助PBC的一小群患者的临床结果。
使用术中计算机断层扫描（CT）设备（CereTom，Neurologica，美国马萨诸塞州丹弗斯）获取层厚2毫米的CT扫描图像。数据被传输到神经导航系统规划工作站（BrainLab，德国费尔德kirchen）。使用软触摸配准系统进行图像配准。在图像引导下，确定一条轨迹，并使用神经导航和哈特尔标志对卵圆孔进行插管。
对13例患者（4例女性，9例男性）进行了16次手术，无并发症发生。所有病例手术总时长均不超过57分钟。
我们认为，图像引导神经导航对处于PBC学习曲线初期的神经外科医生很有用。对于因解剖结构显著变异导致卵圆孔穿刺失败的特定患者，它也可能是一种替代方法。
