Robot-assisted percutaneous balloon compression for trigeminal neuralgia- preliminary experiences

Abstract

Objectives This study aims to discuss the availability of robot-assisted percutaneous balloon compression (PBC) for trigeminal neuralgia (TN) and share our preliminary experiences. Methods Patients with TN who underwent robot-assisted PBC from June to September 2022 were enrolled. We designed a fixing plug for robot-assisted PBC, three-dimensional structured light registration was used, puncture trajectory was the line connects the medial third of inner and outer aperture of foramen ovale. Numerical Rating Scale (NRS), Barrow Neurological Institute (BNI) pain and numbness intensity score were used to evaluate the facial pain and numbness. Results Eventually, nine patients were enrolled, the structured light registrations were successfully finished in all patients with a mean registration error of 0.68 mm. All the punctures of foramen ovales were successfully done one-time. Of note, the balloons were all got pear-shaped followed by 150 to 180 s compression. Though, postoperatively, all the patients complained of facial numbness and four patients suffered from transient masseter weakness, all patients got fully or mostly pain relief. It should be noted that is the numbness and weakness gradually relieved during follow-up. Conclusion Three-dimensional structured light registration and robot assisted PBC is an effective choice for patients with TN. Extension line between the medial third of the inner and outer aperture of foramen ovale might be a safe and effective puncture trajectory to this procedure.

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

“…Among patients treated with PBC, the immediate postoperative pain relief rate exceeds 90% [13,14]Meckel's cave is at before the balloon is in ated, and a pear-shaped balloon indicates su cient pressure, thereby forming a small protrusion from the trigeminal nerve ori ce. In addition to the typical pear shape, the balloon can also assume pear-like, oval, circular, irregular, or dumbbell shapes [15], with the pear-shaped balloon being key to surgical success [16]. In this study, the intraoperative balloon morphology for both groups was pear-shaped or dumbbell-shaped.…”