Abstract
Trigeminal neuralgia (TN) is severe facial pain and its pathogenesis remains unclear. For patients who are not responsive to drug treatments or not suitable for microvascular decompression surgery (e.g. elderly patients, unwilling for craniotomy), percutaneous trigeminal rhizotomy (PTR), which intentionally damages the trigeminal ganglion (TG), is commonly used. Efficacy and complications of the PTR depend on the targeting accuracy, which remains a big challenge for surgeons. One of the current PTR practices is to perform multiple needlings to localise the targeting spot that recreates the patient's TN symptoms. Patients must be trained preoperatively to localise facial stimuli and tolerate the discomfort during testing. A somatotopic mapping of the TG individual neurons and their precise innervation territories may overcome this painful testing procedure. This study aimed to establish a human 3D TG somatotopic mapping and correlate it to the surgical landmarks to guide precise localisation and reduce patient discomfort in PTR.