Wang Ran, Han Ying, Lu Lijuan
Department of Pain Management, Nanjing Drum Tower Hospital The Affiliated Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, China.
Pain Res Manag. 2019 Mar 3;2019:9784020. doi: 10.1155/2019/9784020. eCollection 2019.
Radiofrequency thermocoagulation (RFT) through the foramen rotundum has emerged as an alternative for treatment of isolated V2 trigeminal neuralgia. But puncture of the foramen rotundum is difficult and time-consuming. In current study, we introduced the application of a computer-assisted design (CAD) template to guide foramen rotundum cannulation. Meanwhile, we assessed its safety and efficacy in the treatment of isolated V2 trigeminal neuralgia.
From November 2015 to August 2017, thirty-eight patients with isolated V2 trigeminal neuralgia were treated with computed tomography- (CT-) guided RFT through the foramen rotundum in our institution. All cases were reviewed, and patients were divided into the experimental group (=17, puncture with a CAD template) and control group (=21, free-hand puncture) according to the puncture method used. The puncture times, duration of puncture, and duration of operation were collected. The outcome of pain remission was evaluated utilizing the Barrow Neurological Institute's (BNI) pain score. Complications and recurrence of pain were also recorded. Data were compared between groups.
The rate of one-time successful puncture in the experimental group was obviously higher than that in the control group. Mean puncture times in the experimental group was fewer. Average duration of puncture and operation in the experimental group was also shorter than that in the control group. All patients experienced good pain remission (BNI Class I or II) postoperatively. At four follow-up points (7 days, 3 months, 6 months, and 12 months after operation), there was no significant difference in good pain relief rate between the two groups. Meanwhile, no significant difference was found in complications.
CAD template is a safe and precise navigation instrument for RFT treatment of isolated V2 trigeminal neuralgia via the foramen rotundum. Therefore, this novel tool is worthy of clinical promotion.
经圆孔射频热凝术（RFT）已成为治疗孤立性V2三叉神经痛的一种替代方法。但圆孔穿刺困难且耗时。在本研究中，我们介绍了计算机辅助设计（CAD）模板在引导圆孔置管中的应用。同时，我们评估了其在治疗孤立性V2三叉神经痛中的安全性和有效性。
2015年11月至2017年8月，我院对38例孤立性V2三叉神经痛患者采用计算机断层扫描（CT）引导下经圆孔RFT治疗。回顾所有病例，并根据穿刺方法将患者分为实验组（n = 17，使用CAD模板穿刺）和对照组（n = 21，徒手穿刺）。记录穿刺次数、穿刺时间和手术时间。采用巴罗神经学研究所（BNI）疼痛评分评估疼痛缓解情况。记录并发症和疼痛复发情况。对两组数据进行比较。
实验组一次性穿刺成功率明显高于对照组。实验组平均穿刺次数较少。实验组平均穿刺时间和手术时间也短于对照组。所有患者术后疼痛均得到良好缓解（BNI I级或II级）。在四个随访点（术后7天、3个月、6个月和12个月），两组疼痛缓解良好率无显著差异。同时，并发症方面也无显著差异。
CAD模板是一种安全、精确的导航工具，用于经圆孔RFT治疗孤立性V2三叉神经痛。因此，这种新型工具值得临床推广。
