Electromagnetic neuronavigation for the percutaneous treatment of trigeminal neuralgia with balloon compression: technical note and cadaveric validation study

BACKGROUND: Several techniques have been described for the percutaneous treatment of trigeminal neuralgia; however, each has significant drawbacks. We propose a new technique for percutaneous balloon compression of the trigeminal ganglion and distal trigeminal nerve using electromagnetic (EM) neuronavigation.

METHODS: The procedure was performed in 17 consecutive patients with trigeminal neuralgia. Patients were then followed up with telephone interview. We also performed a cadaveric validation study to further investigate the accuracy of the technique using dye.

RESULTS: Excellent clinical outcomes were achieved with a reduction in the median pain score from 10 out of 10 to 0 out of 10 following the procedure. The cadaveric study also demonstrated a high rate of foramen ovale cannulation.

CONCLUSION: EM-based targeting of the foramen ovale and balloon inflation within Meckel's cave is a quick, reproducible and straightforward technique for the percutaneous treatment of trigeminal neuralgia.