IMPROVING SAFETY AND EFFICACY OF RADIOFREQUENCY TRIGEMINAL RHIZOTOMY OF THE FORAMEN OVALE: PROCEDURAL TECHNIQUES TO OPTIMIZE TARGET LOCALIZATION AND CANNULATION
Trigeminal neuralgia (TN): TN is a common neuropathic pain disorder with symptoms of transient pain affecting one or more branches of the trigeminal nerve. Talking, eating, brushing teeth, and slight touching can induce severe and brief pain.
Treatment with RF: Many invasive treatments are currently available for TN patients who respond poorly to oral medication. Among them, radiofrequency trigeminal rhizotomy (RF-TR) treatment is a viable option with reliable initial and long-term clinical efficacy1-2
Nonetheless, patients undergoing RF-TR may develop several complications, such as facial or forehead numbness and eyelash or corneal hypoesthesia. These complications have been associated with neuronal injury, produced by surgical puncture during the thermocoagulation procedure2
Procedure and limitations: The common procedural approach to treat TN is the percutaneous trans-foramen ovale (FO) RF ablation of the Gasserian Ganglion (GG) under fluoroscopic guidance. This approach, although effective, has been associated with treatment failure, recurrent pain, and a higher risk of neurological complications.
Novel RF techniques aiming to optimize anatomical localization of the lesion target (FO) are essential to improve clinical outcomes and patient safety3
Here, we summarize two important studies that assess the efficacy of novel RF-TN approaches. These studies not only highlight the relevance of accurate imaging guidance and bipolar RF size lesion for TN treatment but also showcase the versatility of Boston Scientific technologies for these complex rhizotomy procedures.