The Application Of Percutaneous Puncture Microballoon Compression In The Treatment Of Trigeminal Neuralgia

Objective Combined with clinical practice experience,this paper discusses trigeminal nerve root and its around vessel of complex structure,the anatomical structure of the patent foramen,further study on percutaneous puncture micro balloon compression application in the treatment of trigeminal neuralgia,for the preoperative imaging diagnosis of trigeminal neuralgia and trigeminal nerve dysmenorrhea skin puncture micro balloon compression treatment fault anatomical basis.Methods A total of 10 adult cadaveric head specimens were selected from the anatomic laboratory of hebei university medical school,and the blue dye was infused into the venous system through the internal carotid artery and the vertebral artery.The CT three-dimensional reconstruction of the head of the body was performed,and the specimens were observed under the operation microscope,and the bilateral trigeminal nerve root was dissected in the extroversion,and the relevant data were measured.Open Meckel chamber and exposed trigeminal nerve root and branch,under the operating microscope structure around the trigeminal nerve root anatomical observation,patent foramen anatomical morphology observation,mainly include patent foramen length,shape,size,bone wall patent foramen and carotid artery tube mouth and spines of hole spacing,the CT three-dimensional reconstruction measurement compared with anatomical data from the data.Results In the 20 side specimens,15 side specimens of the cerebellar upper cerebral artery were on the dorsal side of the trigeminal nerve root,6 of which were in contact with the trigeminal nerve root,9 cases had no contact with the trigeminal nerve root.On the side of the trigeminal nerve root of the cerebellar artery,one of the lateral criteria was in contact with the trigeminal nerve root,and 4 cases had no contact with the trigeminal nerve root.CT 3 d reconstruction model,20 specimens of contralateral resin head specimens of 16 superior cerebellar artery dorsal in trigeminal nerve root,seven specimens of lateral contact with trigeminal nerve root,9 cases with trigeminal nerve root was not contact.On the side of the trigeminal nerve root of the cerebellar artery,one of the lateral criteria was in contact with the trigeminal nerve root,and 3 cases had no contact with the trigeminal nerve root.There was no significant difference in the relationship between the anatomical structure and the CT three-dimensional reconstruction of the cerebellar artery and the trigeminal nerve root(P>0.05).There was no significant difference in the relationship between the anatomical structure and the anterior inferior cerebral artery and the trigeminal nerve root(P>0.05).There was no close contact between the basal artery and the trigeminal nerve root in the 20 side specimens of the anatomical structure and CT 3d reconstruction images.In the dissection of the cadaver head,15 sides of the 20 lateral oval holes were oval,accounting for 75%.2 sides are rounded,accounting for 10%;2 sides with pear shape,accounting for 10%;One side is nephroid,accounting for 5%.Among them,8 cases of cadaveric head were symmetrical and identical,and the two specimens were asymmetrical on both sides.In the three-dimensional reconstruction of CT images,16 of the 20 oval holes were oval,accounting for 80%.2 sides are rounded,accounting for 10%;One side is pear shape,accounting for 5%;One side is nephroid,accounting for 5%.Among them,8 cases of cadaveric head were symmetrical and identical,and the two specimens were asymmetrical on both sides.There was no significant difference(P>0.05)in the morphological comparison between the autopsy and CT 3d reconstruction.The length diameter of the oval hole of the 20-side autopsy and CT 3d reconstruction was(7.21 ±0.76)mm and(7.56±0.87)mm respectively.The wide diameter is(3.45±0.52)mm and(3.51±0.51)mm;The inner posterior wall is respectively(4.51±0.62)mm and(4.68±0.53)mm;The outer wall is(2.74±0.31)mm and(2.69±0.22)mm;The distance between the oval hole and the outer mouth of the carotid artery was(12.45±2.29)mm and(12.52 + 2.34)mm.The spacing between the oval hole and the spine was(3.14 ±0.37)mm and(3.29±0.36)mm;There was no statistically significant difference in the measurement data of 20 side autopsy and CT 3d reconstruction of the oval hole(P>0.05).Conclusion Through the anatomy of the cadaver head specimens found that the relationship between trigeminal nerve root and its around vessel closely and structure show diversity,in through the skin puncture micro balloon compression technique should be carefully,to avoid omissions responsible blood vessels and eggs round hole shape and individual differences,should be under imaging guidance puncture,patent foramen puncture in order to improve the accuracy,the maximum extent to reduce postoperative complications.