case_images: PMC10939014_01
case_images: Diagram of surgical procedure. (A) Blocking V2 branch of trigeminal nerve with 1% lidocaine. Red region means main allodynia region in the patient. (B) The position that the electrical stimulator implant.
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case_images: PMC10939014_01_fneur-15-1353882-g001.jpg
case_images: fig1
case_images: Physical examination revealed allodynia in the maxillary nerve control area, primarily in the paranasal alar and upper lip (Figure 1A, red region). After obtaining informed consent from the patient, we administered a 1% lidocaine (2 mL in total) maxillary nerve block, which led to effective pain relief (Figure 1A). PNFS-stimulating electrode (Implantable DRG Electrode SCL-302E, Rishena Medical, Changzhou, China) was inserted through the foramen rotundum in the vicinity of the maxillary nerve branch (Figure 1B). Postoperatively, there was a remarkable reduction in the NRS pain score, decreasing from 8/10 to a range of 1-3/10.
case_images: Radiographs of the maxillary branch electrode implanted through the foramen rotundum region (arrow). (A) Skull anteroposterior, C-arm angulation (LAO 10 , CRAN 6 ). (B) Skull lateral, C-arm angulation (LAO 106 , CRAN 3 ).
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case_images: PMC10939014_01_fneur-15-1353882-g002.jpg
case_images: fig2
case_images: About 6.5 cm of depth was inserted from skin to foramen rotundum (see Figure 2).
case_images: The key point of surgical steps for stage II. (A-E) The electrode is then tunneled from the entry point to IPG site using "needle-over-the-stylet" technique. (F) The implantable pulse generator was positioned within a subcutaneous pocket beneath the clavicle.
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case_images: PMC10939014_01_fneur-15-1353882-g003.jpg
case_images: fig3
case_images: Once all connections were firmly established, the implantable pulse generator was positioned within a subcutaneous pocket beneath the clavicle and anchored to the thoracic fascia with nonabsorbable sutures (Figure 3).
case_images: Change in NRS (A) and dose of drug (B) from the preoperative evaluation to postoperative period at 1-day, 1-month, 3-month, 6-month, and 1-3-year.
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case_images: PMC10939014_01_fneur-15-1353882-g004.jpg
case_images: fig4
case_images: Figure 4 illustrates the change in NRS scores and drug dosage from the preoperative evaluation to the 1-day, 1-month, 3-month, and 6-month postoperative periods.