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Identification of Foramen Ovale With H-Figure Fluoroscopic Landmark Improves Treatment Outcomes in Idiopathic Trigeminal Neuralgia.

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机构： [1]From the Department of Pain Management, Xuanwu Hospital, Capital Medical University, Beijing, China. [2]Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, California. [3]Department of Pain Treatment, The First Affiliated Hospital of Shandong First Medical University, Jinan, China. [4]Stroke Acute Care Center, Department of Pain Management, Xuanwu Hospital, Capital Medical University, Beijing, China.

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Because it is traditionally difficult and time-consuming to identify the foramen ovale (FO) with fluoroscopy, we recently developed the H-figure method to acquire fluoroscopic view of FO with shorter procedure time and less radiation. However, the impact of such an H-figure approach on the clinical outcomes of trigeminal ganglion radiofrequency thermocoagulation (RFT) in treating idiopathic trigeminal neuralgia (ITN) remains unclear.In a 12-month follow-up retrospective cohort study, patients with ITN had fluoroscopy-guided RFT of trigeminal ganglion via either classic approach (n = 100) or H-figure approach (n = 136) to identify FO. Data of continuous variables were analyzed with a Shapiro-Wilk test for normality and subsequently with a Mann-Whitney test, and the binary data were analyzed with a χ2 test. The primary outcome was the facial pain measured by a Visual Analog Scale (VAS) 1 year after the treatment. The secondary outcomes included the quality of the fluoroscopic FO views, the threshold voltage to provoke paresthesia, the procedure time, the number of fluoroscopic images, and the facial numbness VAS.Compared with the classic approach group, the H-figure approach group was associated with better long-term pain relief after the procedure, with significantly fewer patients had pain 3 months (6.6% vs 17.0%, P = .012) and 12 months (21.3% vs 38.0%, P = .005) after the procedure, and among patients who had pain after the procedure, patients in the H-figure group had significantly less pain 6 months after the procedure (VAS median [interquartile range (IQR)]: 3 [2-6] vs 6 [4-7], P < .001). Moreover, compared to the classic approach, the H-figure approach provided better fluoroscopic view of FO, lower threshold voltage to elicit paresthesia (median [IQR]: 0.2 [0.2-0.3] vs 0.4 [0.4-0.5] V, P < .0001), with shorter procedure time (median [IQR]: 7.5 [6.0-9.0] vs 14.0 [10.0-18.0] min, P < .0001), and required fewer fluoroscopic images (median [IQR]: 4.0 [3.0-5.0] vs 8.0 [6.0-10.0], P < .0001).RFT of the trigeminal ganglion using the H-figure approach is associated with superior longer term clinical pain relief than the classic approach in treating ITN.Copyright © 2022 International Anesthesia Research Society.

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出版当年[2021]版：

大类 | 2 区

医学

小类 | 2 区麻醉学

最新[2023]版：

大类 | 2 区

医学

小类 | 2 区麻醉学

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出版当年[2020]版：

Q1 ANESTHESIOLOGY

最新[2023]版：

Q1 ANESTHESIOLOGY

影响因子： 4.6 最新[2023版] 5.6 最新五年平均 5.178 出版当年[2020版] 4.962 出版当年五年平均 4.305 出版前一年[2019版] 6.627 出版后一年[2021版]

第一作者：

第一作者机构： [1]From the Department of Pain Management, Xuanwu Hospital, Capital Medical University, Beijing, China. [2]Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, California.

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通讯作者：

通讯机构： [2]Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, California. [*1]Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, CA94143.

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