The Affiliated Zhongda Hospital, Southeast University, Southeast University Zhongda Hospital, Jiangsu Province, China.
2Zhejiang Chinese Medical University, Hangzhou, Zhejiang, Province, China; First Affiliated Hospital of Jiaxing University, Jiaxing,Zhejiang Province, China.
Pain Physician. 2022 Mar;25(2):E293-E298.
The Gasserian ganglion (GG) is the primary neuronal aggregation area of the trigeminal nervous system and the epidural structure outside the central nervous system, thus, it has become the most commonly used target for minimally invasive treatment of trigeminal neuralgia (TN). Whether it is the classic trigeminal radiofrequency treatment or GG balloon compression therapy, the intervention target is the GG. The anatomy and imaging anatomy of the GG of the trigeminal nerve is of great importance in the minimally invasive treatment of TN.
To study the anatomy of the trigeminal nerve and multimodal image fusion, and to provide a basis for a clinical minimally invasive interventional treatment forTN.
Review, clinical research study.
Department of Anesthesiology and Pain Medical Center, Jiaxing, China.
Dissect the general structure of the trigeminal nerve and its positional relationship with adjacent structures, and use computed tomography (CT) and magnetic resonance imaging (MRI) to observe the trigeminal nerve, and then, perform a fusion of the CT/MR images.
The GG of the trigeminal nerve is located in Meckel's cave of the middle cranial fossa, and the 3 branches of the nerve fibers are intertwined. CT could only clearly show the bony structures adjacent to the GG, rather than the GG in the body, which was inconsistent with MR images. The bony structure was blurred, while the Meckel's cave and nerve roots, where the trigeminal nerve is located, could be clearly distinguished. Fusing the CT/MR images could provide 2 complementary advantages.
It does not prove the the balloon position thought to be a "dumbbell" shape is adequate for the successful treatment.
Based on the anatomical structure and position of the trigeminal nerve, it is difficult to achieve highly selective branch treatment of TN with radiofrequency in the GG. For the treatment of TN with percutaneous microballoon compression on the GG, the balloon catheter should be placed in Meckel's cave. While it is not easy to insert into Meckel's cave, the depth of the balloon catheter should be that the distal end is flush with the top of the temporal bone petrous cone.
三叉神经节（Gasserian ganglion，GG）是三叉神经系统的主要神经元聚集区和中枢神经系统外的硬膜结构，因此，它已成为治疗三叉神经痛（trigeminal neuralgia，TN）的微创治疗中最常用的靶点。无论是经典的三叉神经射频治疗还是 GG 球囊压迫治疗，干预靶点都是 GG。三叉神经 GG 的解剖结构和影像学解剖结构在 TN 的微创治疗中非常重要。
研究三叉神经解剖结构和多模态影像融合，为临床微创介入治疗 TN 提供依据。
综述，临床研究。
中国嘉兴市麻醉与疼痛医学中心。
解剖观察三叉神经的一般结构及其与邻近结构的位置关系，并用计算机断层扫描（computed tomography，CT）和磁共振成像（magnetic resonance imaging，MRI）观察三叉神经，然后对 CT/MR 图像进行融合。
三叉神经 GG 位于中颅窝的 Meckel 腔，3 支神经纤维交织在一起。CT 只能清楚地显示 GG 邻近的骨结构，而不是 GG 体部，与 MRI 图像不一致。骨结构模糊，而三叉神经所在的 Meckel 腔和神经根可以清晰区分。融合 CT/MR 图像可以提供 2 种互补的优势。
不能证明认为是“哑铃”形状的球囊位置足以治疗成功。
基于三叉神经的解剖结构和位置，射频在 GG 中很难实现对 TN 的高度选择性分支治疗。对于经皮 GG 微球囊压迫治疗 TN，球囊导管应置于 Meckel 腔。虽然将球囊导管插入 Meckel 腔并不容易，但球囊导管的深度应使远端与颞骨岩锥顶平齐。
