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Placement of Needle in the Foramen

Last Updated: September 30, 2018

Strategies for placement of the needle or cannula within the foramen ovale

Placement of the needle within the foramen can be challenging because of variations of the foraminal anatomy and the presence of intraforaminal ridges. The experience of the surgeon plays an important role in successful foraminal cannulation.

To complete a successful percutaneous rhizotomy, the foramen ovale must be accessed using Härtel’s technique. This technique is used regardless of the percutaneous modality (balloon compression, radiofrequency lesioning, or glycerol rhizotomy). Performance of a rhizotomy via each modality is discussed separately.

Operative Anatomy

The following images show the relevant anatomy of the foramen ovale.

Figure 1: Osseous anatomy of the middle cranial base. Note the relation...