Neuronavigation for Trigeminal Rhizotomy

Background Foramen ovale cannulation is required of radiofrequency ablation, balloon compression, and glycerol rhizotomy. Intraoperative CT for neuronavigation is a viable adjunct to these classic procedures. Multiple groups have demonstrated the use of intraoperative neuronavigation with CT and/or MRI in radiofrequency ablation or balloon compression rhizotomy for trigeminal neuralgia.

Objective We describe application of intraoperative CT neuronavigation in trigeminal glycerol rhizotomy.

Methods We present a case series of nine patients who underwent glycerol rhizotomy with intraoperative CT neuronavigation and subsequent confirmatory intraoperative CT for needle placement.

Conclusion Intraoperative neuronavigation provides a practical, reliable, and accurate route to the foramen ovale and may be especially useful in the case of difficult cannulations. In an era of feasible intraoperative guidance, these techniques can be applied to foramen ovale cannulation for glycerol rhizotomy without undue strain.