The foramen ovale: a keyhole to the brain? Computer simulations of percutaneous FO punctures

Abstract Background The percutaneous cannulation of the foramen ovale (FO) is implemented in treating trigeminal neuralgia, diagnosing temporal lobe epilepsy and biopsy petroclival lesions. This study dealt with question whether it possible to reach intracerebral structures a puncture beyond Gasserian Ganglion (GG) without bone destruction or perforating vascularity. Methods We considered FO natural keyhole performed computer-simulated punctures through right left eight structures. Therefore, we took Hartel Submandibular (SM) approach as starting point planned trajectories stereotactic planning software by using brain scans ten patients. Results simulated directly reached hippocampus (20 out 20 trajectories), lateral ventricle (15/20) amygdala (2/20). pons was (20/20); however, pontine vascularity within course. thalamus (13/20) ran mesencephalon. SM (18/20), (5/20) putamen (20/20). nucleus caudatus (20/20) pierced hippocampus, maxillary artery. courses (7/20) sinus cavernosus could not be approach. Conclusions indicates that ventricle, harming major vessels destruction. For implementation these clinical setting, necessary prove cadaveric studies.