Advancing frameless stereotactic navigation for precise targeting of the foramen ovale during radio-frequency thermal ablation (RFTA) for trigeminal neuralgia in anesthetized patients using triggered electromyography - Summary - MDSpire
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Advancing frameless stereotactic navigation for precise targeting of the foramen ovale during radio-frequency thermal ablation (RFTA) for trigeminal neuralgia in anesthetized patients using triggered electromyography
To enhance the precision of RFTA for trigeminal neuralgia by using triggered electromyography (T-EMG) for real-time navigation to the foramen ovale and Gasserian ganglion, potentially improving patient outcomes.
Key Findings:
96% success rate in locating the foramen ovale using T-EMG, indicating high reliability of the technique.
Median stimulus intensity to acquire a compound muscle action potential (CMAP) was 4.5 mA, suggesting effective stimulation parameters.
61.5% of patients reported improvement in facial pain post-procedure, highlighting the clinical relevance of the findings.
Interpretation:
The use of T-EMG significantly improves the accuracy of RFTA procedures for trigeminal neuralgia, potentially leading to better patient outcomes and reduced complications.
Limitations:
Single institution study with a small sample size of 27 procedures, which may limit generalizability.
Follow-up data was not available for one patient, limiting outcome assessment.
Conclusion:
T-EMG combined with stereotactic navigation enhances the precision of RFTA for trigeminal neuralgia, with a high success rate in targeting the foramen ovale and favorable patient outcomes, suggesting a shift in clinical practice.
Patients with preoperative vitamin D deficiency had higher postoperative pain scores and opioid use after mastectomy, including more than triple the odds of moderate to severe pain within 24 hours of surgery.
