Abstract：
The nerve block is a safe and effective method to theat trigeminal neuralgia (TN). In terms of the V2 trigeminal neuralgia, the most difficult procedure in nerve block is accurate and fast greater palatine foramen (GPF) insertion. In this study, we developed a new technique using a personalised digital tooth-supported guide plate to increase insertion accuracy and success rates and reduce the pain of patients during injection. A total of 18 patients with TN (11 female and 7 male) were enrolled and treated between September 2020 and June 2022. Before injection, the guide plate was designed via Mimics three-dimensional (3D) reconstruction technology and printed via 3D printer. Then, all patients underwent maxillary nerve block with a guide plate for each injection. In this study, placement of all guide plates was completed within one minute and all punctures were successful the first time. The depth of the injection needle was over 2.5 cm in all cases and the guide plate was stability-supported by the maxillary teeth. The various pain scores had an obvious improvement. No patients presented symptoms of local anaesthetic toxicity or onset of new neurological sequelae. Using this new technology, we can significantly reduce the difficulty of GPF insertion and decrease patient pain during injection. The enhanced success rate of nerve block can achieve better therapeutic effect. For surgeons, personalised digital tooth-supported guide plates make the operation easier, especially for novice surgeons.
摘要：
神经阻滞是治疗三叉神经痛（TN）安全有效的方法。就V2三叉神经痛而言，神经阻滞中最困难的手术是准确、快速地插入腭大孔(GPF).在这项研究中,我们开发了一种新技术,使用个性化的数字牙托导向板,以提高插入的准确性和成功率,并减少患者在注射过程中的疼痛.在2020年9月至2022年6月期间，共纳入18例TN患者（11例女性和7例男性）并接受治疗。注射前,引导板是通过模拟三维（3D）重建技术设计的，并通过3D打印机打印。然后，所有患者均接受上颌神经阻滞，每次注射均使用导向板。在这项研究中,所有导向板的放置在一分钟内完成，所有穿刺均在第一时间成功。在所有情况下，注射针的深度均超过2.5cm，并且导向板由上颌牙齿稳定支撑。各项疼痛评分均有明显改善。没有患者出现局部麻醉毒性或新的神经系统后遗症的症状。使用这项新技术，我们可以显着降低GPF插入的难度，并减轻患者在注射过程中的疼痛。增强的神经阻滞成功率可以达到更好的治疗效果。对于外科医生来说，个性化的数字牙齿支撑导板使操作更容易，尤其是新手外科医生。
