Anatomic and Radiologic Study of Foramen Ovale Puncture: Implications in Percutaneous Trigeminal Rhizotomy

Objective: Percutaneous trigeminal rhizotomy (PTR), including balloon compression, radiofrequency thermoregulation, and glycerol injection, is a widely used procedure for trigeminal neuralgia. However, aberrant anatomy and neurovascular complications still pose significant challenges to neurosurgeons. Injury to the extracranial internal carotid artery or intracranial structures related to cannulation of the foramen ovale can be fatal. Herein, we present a comprehensive analysis that combines anatomical, radiological, and surgical considerations of foramen ovale puncture.