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一种用于三叉神经痛经皮手术的实验动物模型。

An experimental animal model for percutaneous procedures used in trigeminal neuralgia.

作者信息

Herta Johannes, Wang Wei-Te, Höftberger Romana, Breit Sabine, Kneissl Sibylle, Bergmeister Helga, Ferraz-Leite Heber

机构信息

Department of Neurosurgery, Medical University of Vienna, Vienna, Austria.

Institute of Neurology, Medical University of Vienna, Vienna, Austria.

出版信息

Acta Neurochir (Wien). 2017 Jul;159(7):1341-1348. doi: 10.1007/s00701-017-3162-8. Epub 2017 Apr 10.

Abstract

OBJECT

This study describes an experimental rabbit model that allows the reproduction of percutaneous operations that are used in patients with trigeminal neuralgia (TN). Attention was given to an exact anatomical description of the rabbit's middle cranial fossa as well as the establishment of conditions for a successful procedure.

METHODS

Morphometric measurements were taken from 20 rabbit skulls and CT scans. The anatomy of the trigeminal nerve, as well as its surrounding structures, was assessed by bilateral dissection of 13 New Zealand white rabbits (NWR). An ideal approach of placing a needle through the foramen ovale to reach the TG was sought. Validation of correct placement was realized by fluoroscopy and confirmed by dissection.

RESULTS

Precise instructions for successful reproduction of percutaneous procedures in NWR were described. According to morphological measurements, for balloon compression of the trigeminal ganglion (TG) the maximal diameter of an introducing cannula is 1.85 mm. The diameter of an empty balloon catheter should not exceed 1.19 mm, and the length of the inflatable part of the balloon can range up to 4 mm. For thermocoagulation the needle electrodes must not exceed an external diameter of 1.39, mm and the length of the non-insolated tip can range up to 4 mm. Glycerol rhizolysis can be achieved because the trigeminal cistern in the NWR is a closed space that allows a long dwelling time (>10 min) of the contrast agent.

CONCLUSIONS

An experimental NWR model intended for the reproduction of percutaneous procedures on the TG has been meticulously described. This provides a tool that enables further standardized animal research in the field of surgical treatment of TN.

摘要

目的

本研究描述了一种实验性兔模型,该模型可重现用于三叉神经痛(TN)患者的经皮手术。重点关注兔中颅窝的精确解剖描述以及成功手术条件的建立。

方法

对20个兔头骨进行形态测量并进行CT扫描。通过对13只新西兰白兔(NWR)进行双侧解剖,评估三叉神经及其周围结构的解剖情况。寻找一种将针穿过卵圆孔到达三叉神经节(TG)的理想方法。通过荧光透视法验证正确放置,并通过解剖确认。

结果

描述了在NWR中成功重现经皮手术的精确指导。根据形态测量结果,对于三叉神经节球囊压迫术,导入套管的最大直径为1.85毫米。空球囊导管的直径不应超过1.19毫米,球囊可膨胀部分的长度可达4毫米。对于热凝术,针电极的外径不得超过1.39毫米,非绝缘尖端的长度可达4毫米。可以实现甘油神经根切断术,因为NWR中的三叉神经池是一个封闭空间,可使造影剂长时间停留(>10分钟)。

结论

已详细描述了一种用于在TG上重现经皮手术的实验性NWR模型。这提供了一种工具,可在TN手术治疗领域开展进一步的标准化动物研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5bc2/5486611/d997ab4e9c8c/701_2017_3162_Fig1_HTML.jpg

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