A prospective study of 39 patients with trigeminal neuralgia treated with percutaneous balloon compression

Campos, Wuilker Knoner; Linhares, Marcelo Neves

doi:10.1590/s0004-282x2011000200016

Cited by 26 publications

(23 citation statements)

References 27 publications

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“…7,8 Whatever, most of them are etiologically caused by cerebellovascular compression of the trigeminal root, no matter if directly or indirectly pushed by neoplasms or adhesions in the cerebellopontine angle. 9,10 Nevertheless, the pathophysiology of the disease have not been well understood today.…”

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confidence: 99%

Effectiveness and Safety of Microvascular Decompression Surgery for Treatment of Trigeminal Neuralgia

Xia¹,

Zhong²,

Zhu³

et al. 2014

Journal of Craniofacial Surgery

103

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Microvascular decompression has been now accepted worldwide as a reasonable treatment for trigeminal neuralgia, yet, as a functional operation in the cerebellopontine angle, this process may be risky and the postoperative outcomes might not be good enough sometimes. To assess the effectiveness and safety of microvascular decompression for treatment of trigeminal neuralgia, we conducted a systematic review. Using the keywords "trigeminal neuralgia", "microvascular decompression", or "neurovascular conflict", manuscripts published in English-language journals and indexed in PubMed between January 1, 2000 and June 1, 2013 on the treatment of trigeminal neuralgia (TN) with microvascular decompression were considered for this study. The success and complications were analyzed. The success in this investigation was defined as complete pain free. Continuous outcomes were summarized using means or medians, and dichotomous outcomes were presented as percentage associated with 95% confidence interval. Twenty-six papers with 6,847 patients were finally enrolled in this review. Among them, the male-to-female ratio was 1:1.4, the left-to-right ratio was 1:1.6, and the pain was located in the innervation of V3 and/or V2 in most of the cases with only 2.3% (0.1-4.7) of V1 exclusively. The average age at surgery was 60.9 years (52.5-64.1) with TN symptoms duration of 24.7 months (6.1-42.1) before microvascular decompression (MVD). Operative findings confirmed the superior cerebellar artery, anterior inferior cerebellar artery, posterior inferior cerebellar artery, and multiple vascular contacts (including veins) as the most common sources of nerve compression. The average follow-up duration was 35.8 months (26.2-56.6). The success rate was 83.5% (79.6-89.1). Complications included incisional infection in 1.3% (0.1-2.5), facial palsy 2.9% (0.5-6.2), facial numbness 9.1% (1.3-19.6), cerebrospinal fluid leak 1.6% (0.7-2.5), and hearing deficit 1.9% (0.2-3.9). The postoperative mortality was 0.1% (0.02-0.2). Accordingly, MVD is the most effective treatment for patients with trigeminal neuralgia. An immediate pain free can be achieved by an experienced neurosurgeon with good knowledge of the regional anatomy. To avoid complications, each single step of the process cannot be overemphasized.

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confidence: 99%

Effectiveness and Safety of Microvascular Decompression Surgery for Treatment of Trigeminal Neuralgia

Xia¹,

Zhong²,

Zhu³

et al. 2014

Journal of Craniofacial Surgery

103

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“…[23456789] The percutaneous procedures are radiofrequency rhizotomy, glycerol rhizotomy, and balloon compression. [234567891213141518192022232426]…”

Section: Discussionmentioning

confidence: 99%

Abducent nerve palsy after microballoon compression of the trigeminal ganglion: Case report

Marchi¹,

Aguiar²,

Moura³

et al. 2017

Surg Neurol Int

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Background:Trigeminal neuralgia (TN) is the most common type of facial neuralgia with incidence of 26.8/100,000 person year. In general, this scenario is characterized by a lancinating, unilateral, paroxysmal pain in the area of the fifth cranial nerve. Several treatment methods, including the injection of ethyl alcohol or butyl alcohol into the ganglion, the glycerol injection into the trigeminal cistern, peripheral nerve divisions, the radiofrequency thermocoagulation of the preganglionic fibers, and radiosurgery has been used for TN.Case Description:A case of a 74-year-old woman patient who undergone a treatment of TN through a compression of Meckel cave and developed a transient abducent palsy is presented. Complication regarding to a palsy of abducent nerve is discussed as well as the analysis of presumable evolving physiopathology. A critical review of literature was performed.Conclusions:Among the procedures, we mean that percutaneous microballoon compression (PMC) is the best choice for elderly frail patients, because it had a very low associated mortality-morbidity rate and does not damage permanent the Gasserian ganglion.

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“…Percutaneous microballoon compression on the trigeminal ganglion is a brand new operation technique for trigeminal neuralgia treatment[7891011]. Because of minimal invasiveness, safety, high efficacy, shortened procedure time and no pain during operation, percutaneous microballoon compression has been widely accepted and preferred in many treatment centers.…”

Section: Introductionmentioning

confidence: 99%

Optimal duration of percutaneous microballoon compression for treatment of trigeminal nerve injury

Han

et al. 2014

Neural Regen Res

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Percutaneous microballoon compression of the trigeminal ganglion is a brand new operative technique for the treatment of trigeminal neuralgia. However, it is unclear how the procedure mediates pain relief, and there are no standardized criteria, such as compression pressure, compression time or balloon shape, for the procedure. In this study, percutaneous microballoon compression was performed on the rabbit trigeminal ganglion at a mean inflation pressure of 1,005 ± 150 mmHg for 2 or 5 minutes. At 1, 7 and 14 days after percutaneous microballoon compression, the large-diameter myelinated nerves displayed axonal swelling, rupture and demyelination under the electron microscope. Fragmentation of myelin and formation of digestion chambers were more evident after 5 minutes of compression. Image analyzer results showed that the diameter of trigeminal ganglion cells remained unaltered after compression. These experimental findings indicate that a 2-minute period of compression can suppress pain transduction. Immunohistochemical staining revealed that vascular endothelial growth factor expression in the ganglion cells and axons was significantly increased 7 days after trigeminal ganglion compression, however, the changes were similar after 2-minute compression and 5-minute compression. The upregulated expression of vascular endothelial growth factor in the ganglion cells after percutaneous microballoon compression can promote the repair of the injured nerve. These findings suggest that long-term compression is ideal for patients with recurrent trigeminal neuralgia.

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A prospective study of 39 patients with trigeminal neuralgia treated with percutaneous balloon compression

Cited by 26 publications

References 27 publications

Effectiveness and Safety of Microvascular Decompression Surgery for Treatment of Trigeminal Neuralgia

Effectiveness and Safety of Microvascular Decompression Surgery for Treatment of Trigeminal Neuralgia

Abducent nerve palsy after microballoon compression of the trigeminal ganglion: Case report

Optimal duration of percutaneous microballoon compression for treatment of trigeminal nerve injury

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