Repeated Percutaneous Balloon Compression for Recurrent Trigeminal Neuralgia: A Long-Term Study

Chen, Jyi-Feng; Tu, Po‐Hsun; Lee, Shih‐Tseng

doi:10.1016/j.wneu.2011.06.013

Cited by 41 publications

(27 citation statements)

References 12 publications

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“…Abdennebi et al [24] reported complications including dysesthesia (10.6 % of the 150 patients), transient masticatory weakness (6.6 %), and diminished corneal reflex (2.6 %). Chen et al [25] reported that 100 % of the patients experienced facial numbness after PBC, and 18.8 % suffered masticatory weakness. In our study, the rate of masseter muscle weakness was higher than those previously reported [19,24,25], and it might be related to our longer compression time (3-8 min, mean 6.2 min).…”

Section: Discussionmentioning

confidence: 99%

“…Chen et al [25] reported that 100 % of the patients experienced facial numbness after PBC, and 18.8 % suffered masticatory weakness. In our study, the rate of masseter muscle weakness was higher than those previously reported [19,24,25], and it might be related to our longer compression time (3-8 min, mean 6.2 min). In Skirving and Dan's report [19], the duration of compression was between 2 and 7 min.…”

Section: Discussionmentioning

confidence: 99%

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Percutaneous balloon compression for primary trigeminal neuralgia in patients older than 80 years

Yang

et al. 2015

Chin Neurosurg Jl

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Background: It has been demonstrated that the incidence of trigeminal neuralgia in elderly patients is higher and thus, neurosurgeons often encounter elderly patients with this disorder. However, for those with poor basic condition, the optimal surgical treatment remains controversial. In this study, the authors aimed to evaluate the safety and efficacy of percutaneous balloon compression (PBC) for primary trigeminal neuralgia in elderly patients older than 80 years. Methods: From September 2009 to March 2013, a total of 68 patients older than 80 years underwent PBC, and a retrospective study of the clinical data of these patients was performed. Results: After PBC, pain relief was immediate in 66 (97.0 %) patients, 1 (1.5 %) patient had no pain relief, and 1 (1.5 %) patient had some pain that could be controlled with medication. With a mean length of follow-up of 40.1 months, ranging from 24 to 66 months after surgery, 55 (80.9 %) patients were still pain free. Of the 11 patients with recurrence, 9 cases had mild recurrence and 2 cases suffered severe recurrence. The mean time to recurrence was 18.9 months (1-64 months). Postoperative morbidity included common side effects such as facial numbness in 66 (97.1 %) patients, masseter muscle weakness in 19 (27.9 %) patients, paresthesia in 7 (10.3 %) patients, and diplopia secondary to abducens nerve weakness in 1 (1.5 %) patient. No corneal anesthesia, subarachnoid hemorrhage, or other serious surgical complications occurred in this study. Conclusions: In this study, the authors reviewed data on a cohort of patient older than 80 years. The PBC procedure has advantages in that it is minimally invasive, safe, effective, and could be performed under general anesthesia. This makes it an optimized choice for elderly patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Percutaneous balloon compression for primary trigeminal neuralgia in patients older than 80 years

Yang

et al. 2015

Chin Neurosurg Jl

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“…[ 119 123 ] Repeat PBC, though associated with some increase in complications, is reasonably safe. [ 116 ] Single trigeminal division, primary procedure in the absence of previous operations, and the pear shape balloon are associated to higher pain-free survival. [ 119 120 121 ] Results in MS patients are comparable to classic TN.…”

Section: Percutaneous Balloon Compressionmentioning

confidence: 99%

Trigeminal neuralgia

Yadav

Pande

et al. 2017

Asian J Neurosurg

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Trigeminal neuralgia (TN) is a sudden, severe, brief, stabbing, and recurrent pain within one or more branches of the trigeminal nerve. Type 1 as intermittent and Type 2 as constant pain represent distinct clinical, pathological, and prognostic entities. Although multiple mechanism involving peripheral pathologies at root (compression or traction), and dysfunctions of brain stem, basal ganglion, and cortical pain modulatory mechanisms could have role, neurovascular conflict is the most accepted theory. Diagnosis is essentially clinically; magnetic resonance imaging is useful to rule out secondary causes, detect pathological changes in affected root and neurovascular compression (NVC). Carbamazepine is the drug of choice; oxcarbazepine, baclofen, lamotrigine, phenytoin, and topiramate are also useful. Multidrug regimens and multidisciplinary approaches are useful in selected patients. Microvascular decompression is surgical treatment of choice in TN resistant to medical management. Patients with significant medical comorbidities, without NVC and multiple sclerosis are generally recommended to undergo gamma knife radiosurgery, percutaneous balloon compression, glycerol rhizotomy, and radiofrequency thermocoagulation procedures. Partial sensory root sectioning is indicated in negative vessel explorations during surgery and large intraneural vein. Endoscopic technique can be used alone for vascular decompression or as an adjuvant to microscope. It allows better visualization of vascular conflict and entire root from pons to ganglion including ventral aspect. The effectiveness and completeness of decompression can be assessed and new vascular conflicts that may be missed by microscope can be identified. It requires less brain retraction.

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“…4 Fogarty catheter is then advanced to 10-15 mm beyond the needle tip. The balloon is inflated until proximal to the posterior fossa with approximately 300 mg of I 2 /mL iohexol [29]. Compression volume is patient specific, until pear-shaped balloon is achieved with respect to the nearby structures (e.g., clivus, sella, and petrous bones).…”

Section: Percutaneous Balloon Compression (Pbc)mentioning

confidence: 99%

Interventional Treatment Options for Trigeminal Neuralgia

Eshraghi¹,

Vitug²,

Guirguis³

2020

Peripheral Nerve Disorders and Treatment

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Trigeminal neuralgia is characterized by sudden and severe shock-like episodes of transient unilateral pain in the trigeminal nerve distribution. Most cases are idiopathic and are known to respond favorably to anticonvulsants. For patients who fail at least three drug trials or experience intolerable side effects, surgery may be warranted. First, a diagnostic block at the trigeminal nerve or Gasserian ganglion to confirm clinical diagnosis is performed. Surgical intervention can be either ablative or nonablative, each with its respective indications, contraindications, and risk-benefit profile. Most common are the percutaneous rhizotomies: conventional and pulsed radiofrequency ablation (RFA), chemical glycerol injections, and mechanical balloon compression. Stereotactic or gamma knife radiosurgery (GKRS) is the least invasive with only a moderate duration of pain relief, whereas microvascular decompression (VMD) is the most invasive, but associated with greatest long-term benefit. RFA has consistently shown favorable results and is the only modality with evidence of pain relief in ≥50% of patients treated 20 years postoperatively. Auxiliary interventional options such as peripheral neurectomy, botulinum toxin type-A (BTX-A) injections, and cryotherapy are available for those with contraindications to rhizotomies, radiosurgery, or neurosurgery. Ultimately, physicians must tailor their management of trigeminal neuralgia to the needs of the patient.

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Repeated Percutaneous Balloon Compression for Recurrent Trigeminal Neuralgia: A Long-Term Study

Cited by 41 publications

References 12 publications

Percutaneous balloon compression for primary trigeminal neuralgia in patients older than 80 years

Percutaneous balloon compression for primary trigeminal neuralgia in patients older than 80 years

Trigeminal neuralgia

Interventional Treatment Options for Trigeminal Neuralgia

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