Sphenopalatine Ganglion Block with Botulinum Neurotoxin for Treating Trigeminal Neuralgia Using CAD/CAM-Derived Injection Guide.

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2020-04-01 DOI:10.11607/ofph.2510

Kazuya Yoshida

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引用次数: 5

Abstract

AIMS To examine the effectiveness and safety of using a CAD/CAM-derived injection guide for botulinum neurotoxin block of the sphenopalatine ganglion for trigeminal neuralgia treatment. METHODS Ten patients with second-division trigeminal neuralgia who did not respond to submucosal administration of botulinum neurotoxin were enrolled in this study. The target point around the sphenopalatine fossa was determined after fusion of computed tomography data with a scan of a maxillary model using a software program for dental implant surgery. A CAD/CAM-derived injection guide was fabricated. The guide was affixed to the patient's maxilla, and a needle was inserted to an exactly analyzed depth. Subsequently, 50 units of botulinum neurotoxin were injected. Pain intensity evaluated using a visual analog scale and pain frequency were measured. RESULTS By using the guides, sphenopalatine ganglion block with botulinum toxin was performed 18 times without any complications. The visual analog scale score (8.1 ± 1.0) and pain frequency (19.4 ± 8.8 times/day) decreased (to 1.9 ± 1.4 and 4.9 ± 5.4 times/day, respectively) significantly (P < .001). After 4 weeks, the mean subjective improvement achieved was 77.5% ± 13.8%, and all patients responded to treatment. CONCLUSION Even without prior experience of sphenopalatine ganglion block, the CAD/CAM-derived guide enabled the accurate and safe administration of botulinum neurotoxin to the sphenopalatine ganglion for the treatment of trigeminal neuralgia.

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肉毒毒素阻断蝶腭神经节治疗三叉神经痛的CAD/ cam注射指南。

目的探讨应用CAD/ cam衍生注射指南进行蝶帕神经节肉毒毒素阻滞治疗三叉神经痛的有效性和安全性。方法选取10例黏膜下给药肉毒杆菌神经毒素无效的三叉神经痛患者作为研究对象。蝶腭窝周围的目标点是在使用种植牙手术软件程序将计算机断层扫描数据与上颌模型扫描融合后确定的。制作了CAD/ cam衍生的注射导管。将导针固定在患者的上颌骨上，并将针插入精确分析的深度。随后，注射50单位肉毒杆菌神经毒素。采用视觉模拟量表评估疼痛强度，并测量疼痛频率。结果应用该指南行蝶腭神经节肉毒毒素阻滞18次，无并发症发生。视觉模拟评分(8.1±1.0)和疼痛频率(19.4±8.8次/d)显著降低(分别为1.9±1.4次/d和4.9±5.4次/d) (P < 0.001)。4周后，平均主观改善率为77.5%±13.8%，所有患者均对治疗有反应。结论:即使没有蝶腭神经节阻滞的经验，CAD/ cam衍生的指南也能准确、安全地将肉毒杆菌神经毒素注射到蝶腭神经节治疗三叉神经痛。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.