Percutaneous microcompression of the trigeminal ganglion for trigeminal neuralgia

Mullan, Sean; Lichtor, Terry

doi:10.3171/jns.1983.59.6.1007

Cited by 397 publications

(237 citation statements)

References 12 publications

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“…25 Based on this concept, Sean Mullan introduced the technique of percutaneous balloon compression for TN in 1983. 21,22 Since that first publication, results from more than 800 of these procedures have been reported in the literature. …”

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confidence: 99%

Percutaneous balloon compression for the treatment of trigeminal neuralgia: results in 56 patients based on balloon compression pressure monitoring

Brown

Pilitsis²

2005

FOC

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Object Percutaneous balloon compression is an effective and technically simple method for treating trigeminal neuralgia (TN). Nevertheless, dysesthesias (10–20%) and masseter muscle weakness (66%) following the procedure have been noted. The purpose of this study was to evaluate the results of testing TN with percutaneousballoon compression aided by intraluminal pressure monitoring. Methods In this study the authors review the results and complications associated with percutaneous balloon compression by using intraluminal pressure monitoring data obtained in 65 procedures performed in 56 consecutive patients over 4 years. The mean patient age was 71 years (range 37–92 years), and the mean follow-up duration was 17 months (range 3–38 months). The mean intraluminal compression pressure was (1160 ± 62 mm Hg), and the mean duration of compression was 1.15 ± 0.27 minutes. The trigeminal depressor response was observed in 60 (92%) of 65 procedures, and initial pain relief occurred in 92% of patients. The recurrence rate in patients who had initial relief was 16% (nine of 56). The mean time until recurrence in patients who experienced pain relief after surgery was 13 months (range 3–23 months). Mild numbness immediately after surgery was observed in 83% of patients. At the most recent evaluation, 17% of patients reported persistent, nontroublesome numbness and none had moderate or severe numbness. Minor dysesthesia was present in two patients (4%). Mild masseter muscle weakness occurred in 24% of patients and resolved within a maximum period of 1 year. No patient experienced anesthesia dolorosa, corneal keratitis, or other cranial nerve deficits. These morbidity rates are lower than the incidence reported in the literature when pressure monitoring is not used. Conclusions These data show that by monitoring compression pressure and limiting the duration of compression, it is possible to reduce the incidence of dysesthesias, severe numbness, and masseter weakness after surgery without increasing the rate of recurrent pain in patients with classic TN.

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confidence: 99%

Percutaneous balloon compression for the treatment of trigeminal neuralgia: results in 56 patients based on balloon compression pressure monitoring

Brown

Pilitsis²

2005

FOC

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“…BC was first published in 1983 by Mullan and Lichtor. 8 Since then, it has been used as one of the alternative therapeutic approaches combining high rate of efficacy (with 93-99% initial pain relief), easy performance, and generally low morbidity. 4,9 Corneal anesthesia and anesthesia dolorosa, which occurs with considerable frequency in other ablative techniques such as radiofrequency rhizotomy, 1,3,4 are rare with BC treatment.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Balloon Compression for Trigeminal Neuralgias and Autonomic Cephalalgia

2007

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Objective.-This prospective study aimed to evaluate the results of percutaneous trigeminal ganglion balloon compression (BC) in patients with various types of trigeminal neuralgia (TN) and autonomic cephalalgia.Methods.-Twenty-five consecutive patients underwent BC and were followed up for 27-60 months. They were divided into 2 groups: group A (n = 18) patients with idiopathic TN and group B (n = 7) patients with secondary TN (n = 5) and trigeminal autonomic cephalalgia (TAC) (n = 2).Results.-Postoperatively, 15 patients in group A experienced pain relief, one required medication and 2 had no response; in group B, 6 were free of pain, including the 2 patients with TAC, and one required medication. Complications in both groups were either functionally trivial or infrequent. None of the patients developed keratitis or anesthesia dolorosa. Pain recurrence occurred early (<6 months) in one patient from group B, and late in 2 patients from group A.Conclusion.-Balloon compression is a minimally invasive procedure that seems to be comparably successful for idiopathic and secondary TN, as well as TAC. However, further studies are deemed necessary to establish it as the first-line treatment in medically resistant trigeminal pain.

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“…The lesion was obtained by means of a temperature of 75-80 °C held [15]: under fluoroscopy, a #4 Fogarty arterial catheter was introduced into the Meckel cave, through a bluntedged thin-walled cannula. The balloon was then inflated with 0.75 ml contrast material for 1-10 minutes.…”

Section: Methodsmentioning

confidence: 99%

Surgical treatment of trigeminal neuralgia: results of percutaneous treatment versus microsurgical decompression

et al. 2000

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A patient with trigeminal neuralgia may need different forms of treatment during his or her lifetime. Physicians should be aware of the different available surgical treatments, and know their effectiveness, side effects and complications. Microvascular decompression is considered by many to be the most effective treatment. The goal of the procedure is to remove the cause of pain, obtained by decompressing the nerve at its entry point into the pons. Percutaneous procedures are more easily performed but the recurrence rate of pain is higher. It is difficult to compare the results of surgical procedures reported by different authors. Therefore, we compare the efficacy of 155 microvascular decompressions with 113 radiofrequency thermocoagulations and 215 percutaneous microcompressions performed by the same surgical team. Our study confirms microvascular decompression as the most effective surgical treatment, although percutaneous procedures play an important role in the treatment protocol and have to be offered to patients as a therapeutic option.

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Percutaneous microcompression of the trigeminal ganglion for trigeminal neuralgia

Cited by 397 publications

References 12 publications

Percutaneous balloon compression for the treatment of trigeminal neuralgia: results in 56 patients based on balloon compression pressure monitoring

Percutaneous balloon compression for the treatment of trigeminal neuralgia: results in 56 patients based on balloon compression pressure monitoring

Percutaneous Balloon Compression for Trigeminal Neuralgias and Autonomic Cephalalgia

Surgical treatment of trigeminal neuralgia: results of percutaneous treatment versus microsurgical decompression

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