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

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. 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. 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. 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.