Clinical Analysis of the Treatment of Primary Trigeminal Neuralgia by Percutaneous Balloon Compression

Abstract

PurposeTo summarize the technical points and clinical effects of percutaneous balloon compression (PBC) in the treatment of primary trigeminal neuralgia.MethodsThe clinical data of 13 patients with trigeminal neuralgia who received PBC from April 2020 to July 2021 were retrospectively analyzed. VAS, VRS-4 and PPI were used to evaluate the postoperative pain relief. Different postoperative complications were analyzed.ResultsAll patients had a smooth operation, the inflation volume of the balloon was 0.7 ml, the average compression time was 120 s, and there was no balloon rupture during the operation. On the day after operation, 12 patients (92.3%) had complete pain relief, and 1 patient (7.7%) was not satisfied with pain relief, but the pain disappeared 2 weeks after the operation. After operation, there were 12 patients with facial numbness in the affected side (92.3%), 3 patients with masseter muscle weakness (23.0%), 1 patient with herpes around the mouth (7.6%), and 1 patient with diplopia (7.6%).ConclusionPBC is an effective minimally invasive surgical method for the treatment of primary trigeminal neuralgia. It is suitable for the elderly and infirm people, those who cannot tolerate general anesthesia or are afraid of surgery, and patients who had undergone surgery but relapsed after surgery. However, it is necessary to pay attention to the serious facial numbness and postoperative masticatory weakness. These discomforts are generally relieved after half a year.

Continuous Intra-Arterial Blood Pressure Monitoring Improves the Efficiency of Percutaneous Balloon Compression of the Trigeminal Ganglion for Trigeminal Neuralgia

“…Because of its minimal invasiveness, quick recovery after surgery, and immediate pain relief, PBC is gradually becoming an attractive choice for the treatment of TN, especially in those patients who refuse to undergo open surgery [ 20 , 21 ]. PBC is an effective and safe option for the elderly population and patients with recurrence after MVD or other unsuccessful treatment [ 22 ].…”

Analysis of the Correlation between Percutaneous Balloon Compression Treatment Frequency and Facial Numbness in Trigeminal Neuralgia

“…Many scholars have analyzed the relationship between balloon compression time and postoperative facial numbness. Wang H et al [13] reported an average balloon compression time of 120 s, ranging from 30 to 180 s, with postoperative ipsilateral facial numbness in 12 cases (92.3%) and severe numbness in one patient. Valenzuela Cecchi B et al [2] conducted a 10-year follow-up of 29 TN patients treated with PBC, with 18 of them showing mild symptoms of facial numbness.…”

The Effect of Trigeminal Ganglion Block on Trigeminocardiac Reflex in Elderly Patients with Trigeminal Neuralgia Undergoing Percutaneous Balloon Compression: A Randomized Controlled Study

“…PBC was recommended as the first-choice percutaneous procedure for the treatment of TN, and the efficacy and safety had been demonstrated. 6 , 7 , 21 However, PBC-induced TCR has been reported in numerous studies, 22 which is characterized by significant hemodynamic changes that may be fatal to elderly patients. The TCR is known to occur suddenly without any signal at the moment of puncturing the foramen ovale and compressing the trigeminal ganglion during PBC.…”