CT measurement of maximum transverse diameter of the foramen ovale and the distance between the foramen ovale and the foramen spinosum and its application in the treatment of trigeminal neuralgia
Chu Dantao1, Cheng Yajing2, Huang Bing2, Yao Ming2, Liu Qianying2
1Department of Pain Medicine, the Second Municipal Hospital of Haining, Haining 314200, China; 2Department of Pain Medicine, the First Hospital of Jiaxing, Jiaxing 314000, China
Abstract：Objective To observe the clinical significance of the horizontal transverse diameter of the foramen ovale and the distance between the foramen ovale and to guide the percutaneous transforaminal hole piercing for radiofrequency treatment of trigeminal neuralgia.Methods Clinical data of 200 adult patients undergoing cranial CTA examination in Jiaxing First Hospital from September 2016 to January 2017 were retrospectively analysed and searched for in the thinning sequence successively. Both sides of the oval foramen were selected to be defined clearly. The horizontal transverse diameter and the longest diameter of the bilateral foramen ovale and the distance between the oval hole and the spinous hole were measured by a CT image software tool. Calculate the horizontal transverse diameter, long diameter, and the average distance between the foramen ovale and the spinous foramen. In the patients with primary trigeminal mandibular pain who underwent radiofrequency ablation in the Department of Pain Medicine, First Hospital of Jiaxing, from January 2017 to May 2018, 26 patients with a horizontal diameter greater than the mean value of the imaging results were selected for prospective study.Among them, there were 15 males and 11 females, aged 57-87 (63.4±6.1)years. Patients were randomly divided into the bipolar radiofrequency group (14 patients) and unipolar radiofrequency group (12 patients). Two groups of patients underwent semi-coronal CT scanning. The depth and angle of puncture were measured on CT images with oval foramen, and the puncture path was designed. According to the designed puncture path, single-needle unipolar or double-needle bipolar radiofrequency thermocoagulation was performed. The curative effect of the two groups was observed and compared after operation.Results The results of imaging measurements showed that the maximum horizontal and transverse diameters of the left and right foramen ovale were(5.41±0.91)mm, (5.51±0.88)mm , the maximum length was (7.50±1.29)mm, (7.51±1.10)mm, and the shortest distances between the foramen ovale and the foramen spinosum were (2.08±0.92) mm, (2.17±0.87) mm. There was no significant difference(all P values＞0.05). The results of clinical treatment showed that the operation was successfully completed in both groups, and the efficacy was evaluated during hospitalization. All patients were followed up after discharge for an average of 10.9 months, ranging from 1 to 16 months. During the follow-up period, there were 12 patients in unipolar radiofrequency group, 10 patients were effective and 2 patients were ineffective, and 1 patient of recurrence after 11 months. All the 14 patients in bipolar radiofrequency group were effective without residual pain or recurrence.Conclusions Before the trigeminal mandibular branch pain is treated with extracranial radiofrequency treatment, the CT scan of the horizontal diameter of the foramen ovale can provide an Objective basis for whether to adopt the bipolar radio frequency mode.
褚丹涛, 陈雅静, 黄冰, 姚明, 刘倩影. 卵圆孔最大横径及卵圆孔与棘孔距离的CT影像测量及其在三叉神经痛治疗中的应用[J]. 中华解剖与临床杂志, 2019, 24(1): 52-57.
Chu Dantao, Cheng Yajing, Huang Bing, Yao Ming, Liu Qianying. CT measurement of maximum transverse diameter of the foramen ovale and the distance between the foramen ovale and the foramen spinosum and its application in the treatment of trigeminal neuralgia. Chinese Journal of Anatomy and Clinics, 2019, 24(1): 52-57.
Wan Q, Zhang D, Cao X, et al. CT-guided selective percutaneous radiofrequency thermocoagulation via the foramen rotundum for isolated maxillary nerve idiopathic trigeminal neuralgia[J]. J Neurosurg, 2018, 128(1): 211-214. DOI:10.3171/2016.9.JNS152520
2019, Vol. 24 
