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21KF-059
New insight of the cross-sectional area of the mandibular nerve at the level of foramen: Its clinical significance

Peng-Bo Zhu1,2,Yeon-Dong kim2,3*, Hyung-Sun Won1,2,*

1Department of Anatomy, Wonkwang University School of Medicine

2Jesaeng-Euise Clinical Anatomy Center, Wonkwang University School of Medicine

3Department of Anesthesiology and Pain Medicine, Wonkwang University School of Medicine

Introduction: Trigeminal neuralgia (TN) can be effectively treated by minimally invasive techniques such as microvascular decompression, balloon compression, radiofrequency (RF) thermocoagulation. RF thermocoagulation is widely used for it clinical effectiveness. For the successful outcome, exact position of the needle tip is the most important based on the exact anatomic understanding is essential, as other interventional treatments, from the diagnostic nerve block to the RF thermocoagulation.Mandibular nerve (MN), branch of the trigeminal nerve, is one of the most involved branch related TN. RF thermocoagulation of the MN is commonly performed with fluoroscopic guidance. During the procedures, the accurate positioning of electrode tip to the sensory component of MN within the foramen ovale (FO) is necessary for successful outcome. This study was performed to clarify exact anatomical information related to the localization of an electrode tip to the sensory component of MN at the level of FO.

Materials and Methods: Fifty hemi-half heads from 26 Korean adult cadavers were used for this study.

Results: At the level of FO, the cross-sectional area of the posterior division of MN was significantly larger than that of the anterior division (p < 0.01). The anterior division was mainly located at the anterior or anterolateral or medial half region of FO. When all of the cross-sectional areas of MNs are overwrapped, no anterior divisions invade the target areas; the medial half of lateral part of posterior division.

Conclusion: These results are expected to provide helpful information for the ideal localization of an electrode tip at the level of FO in selective RF thermocoagulation.

Acknowledgement: This work was supported by the National Research Foundation of Korea (NRF) funded by the Ministry of Education (grant no. NRF-2021R1I1A3049699).