Department of Anesthesiology and Pain Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Department of Urology, The Catholic University of Korea, Incheon St. Mary's Hospital, Incheon, Korea.
Pain Physician. 2019 Jul;22(4):E345-E350.
For patients with trigeminal neuralgia who do not respond to medication and for whom surgical approaches are too risky, percutaneous procedures targeting the trigeminal ganglion are the current standard treatment. Percutaneous procedures are performed via the transoval approach under radiologic guidance. Identification of the foramen ovale (FO) under fluoroscopic guidance is an important part of determining the success or failure of the procedures.
Previous studies have described how to visualize the FO under fluoroscopic guidance, but those methods are limited by poor reproducibility. In this study, we have investigated how to visualize the FO clearly and easily under fluoroscopic guidance.
Retrospective analysis.
University hospital in Korea.
Seventy-two 3-dimensional facial computed tomography scans without anatomic abnormalities of the skull base were analyzed for verifying the novel method. First, the mandibular angle and the occipital cortical line were overlapped and then turned by 15° oblique rotation using the software package. After these manipulations, the visualization of the FO was graded according to a 4-point scale (0: poor; 1: fair; 2: good; 3: excellent), and the inferior transfacial and oblique angles were measured.
This enabled clear visualization of the FO. The mean visual grade of 54 right and 46 left FO (total 100) was 2.74 (0: poor; 1: fair; 2: good; 3: excellent). All recorded FOs had at least grade 2 visibility.
This study is lacking application in clinical practice and comparative data to the submental view.
The mandible angle and the occipital cortex line are obvious anatomic landmarks and are visible even to nonexperienced practitioners. Therefore, our method using these anatomic landmarks can improve the reproducibility and accuracy of FO visualization.
Trigeminal neuralgia, foramen ovale, trigeminal ganglion, 3-dimensional (3D) facial computed tomography (CT) scans.
对于药物治疗无效且手术风险较高的三叉神经痛患者，经皮靶向三叉神经节的方法是目前的标准治疗方法。经皮手术在放射学引导下通过经卵圆孔入路进行。在透视引导下确定卵圆孔（FO）的位置是确定手术成败的重要部分。
先前的研究已经描述了如何在透视引导下观察 FO，但这些方法的可重复性较差。在这项研究中，我们研究了如何在透视引导下清晰、轻松地观察 FO。
回顾性分析。
韩国大学医院。
分析了 72 例无颅底解剖异常的三维面部 CT 扫描，以验证新方法。首先，重叠下颌角和枕皮质线，然后使用软件包旋转 15°斜角。进行这些操作后，FO 的可视化程度根据 4 分制（0：差；1：一般；2：好；3：优秀）进行评分，并测量下脸和面角。
这使得 FO 能够清晰地显示出来。54 个右侧和 46 个左侧 FO（共 100 个）的平均视觉等级为 2.74（0：差；1：一般；2：好；3：优秀）。所有记录的 FO 均具有至少 2 级的可见度。
本研究缺乏在临床实践中的应用和与颏下视图的比较数据。
下颌角和枕皮质线是明显的解剖标志，即使是非经验丰富的医生也能看到。因此，我们使用这些解剖标志的方法可以提高 FO 可视化的可重复性和准确性。
三叉神经痛，卵圆孔，三叉神经节，三维（3D）面部 CT 扫描。
