Application of Customized Navigated Template for Percutaneous Radiofrequency Thermocoagulation Treatment of Primary Trigeminal Neuralgia


Objective: To investigate the successful rate and accuracy of percutaneous radiofrequency thermocoagulation (PRT) for treatment of primary trigeminal neuralgia (PTN) with customized navigated template via three dimensional (3D) printing technique. Methods: 65 patients with PTN were recruited from January 2014 to March 2015 and randomly divided into two groups: template group (n = 28) and traditional group (n = 37). The patients in traditional group received PRT under guidance of C-arm fluoroscopy, while the ones in template group were treated with customized navigated templates. The data of time, depth and accuracy rate of puncture, the average effective dose equivalent of radiation, complications after operation were collected and analyzed. Results: No intra-operative failures occurred in the template group: the pain was alleviated immediately after operation. Accuracy rate of the template group was 100% while 96% was achieved in traditional group. However, the average time of puncture by the template was significantly reduced compared with traditional group (2.37 ± 0.64 minutes and 24.2 ± 6.55 minutes, respectively; P < 0.001). Meanwhile, the average effective dose equivalent of radiation was apparently reduced compared to the traditional group. The depth of puncture in operation was mostly close to the results of simulation (9.45 ± 0.58 cm and 9.33 ± 0.87 cm respectively, P > 0.05). No complications were observed in template group while several complications such as blooding, leakage of cerebrospinal fluid and dizziness were observed in traditional group. Conclusion: The application of customized template is advocated for improving the accuracy of PRT.

Share and Cite:

Wang, P. , Gu, T. , Zhang, Z. , Wu, H. and Ji, D. (2015) Application of Customized Navigated Template for Percutaneous Radiofrequency Thermocoagulation Treatment of Primary Trigeminal Neuralgia. Chinese Medicine, 6, 175-180. doi: 10.4236/cm.2015.63019.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Andre, N.A. (1756) Observations Pratiques Sur Les Maladies de L’Uretre. Chez Delaguette, Imprimeur de College et de L’Academie Roy de Chir, Paris, 318-382.
[2] Gronseth, G., Cruccu, G., Alksne, J., Argoff, C., Brainin, M., Burchiel, K., et al. (2008) Practice Parameter: The Diagnostic Evaluation and Treatment of Trigeminal Neuralgia (An Evidence-Based Review): Report of the Quality Standards Subcommittee of the American Academy of Neurology and the European Federation of Neurological Societies. Neurology, 71, 1183-1190.
[3] Guo, Z., Ouyang, H. and Cheng, Z. (2011) Surgical Treatment of Parapontine Epidermoid Cysts Presenting with Trigeminal Neuralgia. Journal of Clinical Neuroscience, 18, 344-346.
[4] Sindrup, S.H. and Jensen, T.S. (2002) Pharmacotherapy of Trigezminal Neuralgia. Clinical Journal of Pain, 18, 22-27.
[5] Zakrzewska, J.M. and Linskey, M.E. (2014) Trigeminal Neuralgia. BMJ Clin Evid, pii: 1207.
[6] Montano, N., Papacci, F., Cioni, B., Di Bonaventura, R. and Meglio, M. (2013) What Is the Best Treatment of Drug-Resistant Trigeminal Neuralgia in Patients Affected by Multiple Sclerosis? A Literature Analysis of Surgical Procedures. Clinical Neurology and Neurosurgery, 115, 567-572.
[7] Akram, H., Mirza, B., Kitchen, N. and Zakrzewska, J.M. (2013) Proposal for Evaluating the Quality of Reports of Surgical Interventions in the Treatment of Trigeminal Neuralgia: The Surgical Trigeminal Neuralgia Score. Neurosurgical Focus, 35, E3.
[8] Gu, W. and Zhao, W. (2014) Microvascular Decompression for Recurrent Trigeminal Neuralgia. Journal of Clinical Neuroscience, 21, 1549-1553.
[9] Oesman, C. and Mooij, J.J. (2011) Long-Term Follow-Up of Microvascular Decompression for Trigeminal Neuralgia. Skull Base, 21, 313-322.
[10] Karol, E.A., Sanz, O.P., Gonzalez La Riva, F.N. and Rey, R.D. (1993) A Micrometric Multiple Electrode Array for the Exploration of Gasserian and Retrogasserian Trigeminal Fibers: Preliminary Report: Technical Note. Neurosurgery, 33, 154-158.
[11] Smith, H.P., McWhorter, J.M. and Challa, V.R. (1981) Radiofrequency Neurolysis in a Clinical Model: Neuropatho-logical Correlation. Journal of Neurosurgery, 55, 246-253.
[12] Gusmão, S., Oliveira, M., Tazinaffo, U. and Honey, C.R. (2003) Percutaneous Trigeminal Nerve Radiofrequency Rhizotomy Guided by Computerized Tomography Fluoroscopy. Technical Note. Journal of Neurosurgery, 99, 785-786.
[13] Xu, S.J., Zhang, W.H., Chen, T., Wu, C.Y. and Zhou, M.D. (2006) Neuronavigator-Guided Percutaneous Radiofrequency Thermocoagulation in the Treatment of Intractable Trigeminal Neuralgia. Chinese Medical Journal (English Edition), 119, 1528-1535.
[14] Erdine, S., Ozyalcin, N.S., Cimen, A., Celik, M., Talu, G.K. and Disci, R. (2007) Comparison of Pulsed Radiofrequency with Conventional Radiofrequency in the Treatment of Idiopathic Trigeminal Neuralgia. European Journal of Pain, 11, 309-313.
[15] Hirao, M., Ikemoto, S. and Tsuboi, H. (2014) Computer Assisted Planning and Custom-Made Surgical Guide for Malunited Pronation Deformity after First Metatarsophalangeal Joint Arthrodesis in Rheumatoid Arthritis: A Case Report. Computer Aided Surgery, 19, 13-19.
[16] Raaijmaakers, M., Gelaude, F., De Smedt, K., Clijmans, T., Dille, J. and Mulier, M. (2010) A Custom-Made Guide-Wire Positioning Device for Hip Surface Replacement Arthroplasty: Description and First Results. BMC Musculoskeletal Disorders, 11, 161.
[17] Modabber, A., Ayoub, N., Möhlhenrich, S.C., Goloborodko, E., Sönmez, T.T., Ghassemi, M., et al. (2014) The Accuracy of Computer-Assisted Primary Mandibular Reconstruction with Vascularized Bone Flaps: Iliac Crest Bone Flap versus Osteomyocutaneous Fibula Flap. Medical Devices: Evidence and Research, 7, 211-217.
[18] Liu, Y.F., Xu, L.W., Zhu, H.Y., Liu, S.-Y.S. (2014) Technical Procedures for Template-Guided Surgery for Mandibular Reconstruction Based on Digital Design and Manufacturing. BioMedical Engineering OnLine, 13, 63.
[19] Farzadi, A., Solati-Hashjin, M. and Asadi-Eydivand, M. (2014) Effect of Layer Thickness and Printing Orientation on Mechanical Properties and Dimensional Accuracy of 3D Printed Porous Samples for Bone Tissue Engineering. PLoS ONE, 9, e108252.
[20] Ventola, C.L. (2014) Medical Applications for 3D Printing: Current and Projected Uses. Pharmacy and Therapeutics, 39, 704-711.
[21] Parthasarathy, J. (2014) 3D Modeling, Custom Implants and Its Future Perspectives in Craniofacial Surgery. Annals of Maxillofacial Surgery, 4, 9-18.
[22] Patil, J., Kumar, N., KG, M.R., Ravindra, S.S., SN, S., Nayak, B.S., et al. (2013) The Foramen Ovale Morphometry of Sphenoid Bone in South Indian Population. Journal of Clinical and Diagnostic Research, 7, 2668-2670.
[23] Khairnar, K.B. and Bhusari, P.A. (2013) An Anatomical Study on the Foramen Ovale and the Foramen Spinosum. Journal of Clinical and Diagnostic Research, 7, 427-429.
[24] Yang, J.T., Lin, M., Lee, M.H., Weng, H.H. and Liao, H.H. (2010) Percutaneous Trigeminal Nerve Radiofrequency Rhizotomy Guided by Computerized Tomography with Three-Dimensional Image Reconstruction. Chang Gung Medical Journal, 33, 679-683.
[25] Luo, F., Shen, Y., Wang, T., Meng, L., Yu, X.T. and Ji, N. (2014) 3D CT-Guided Pulsed Radiofrequency Treatment for Trigeminal Neuralgia. Pain Practice, 14, 16-21.

Copyright © 2022 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.