Percutaneous trigeminal ganglion balloon compression rhizotomy: experience in 27 patients

Abstract

Purpose: Percutaneous ganglion balloon compression (PBC) is a minimally invasive procedure for treatment of trigeminal neuralgia.

Materials and methods: Twenty-seven (19 female and 8 male) patients, who presented with classical symptoms of trigeminal neuralgia, were included. Age ranged from 34 to 91 years (median 62 years), 33 procedures were performed. Duration of the symptoms ranged from 1 year to 30 years (median 5 years).

Results: After the procedure, pain relief was reported in 25 (93%) patients. In two patients, the pain remained the same. The pain free period ranged from 2 to 74 months (median 15 months). A mean duration of analgesia was longer in patients with ideal pear shape of balloon at the time of the procedure compared to nonideal shape (P = 0.01). No major complications occurred in our group of patients.

Conclusions: Percutaneous trigeminal ganglion balloon compression is a safe, simple, and effective method for temporary pain relief in a selective group of trigeminal neuralgia patients.

Figure 1

Through the entry point—2.5 cm lateral to the corner of the mouth, a specially designed needle with thin stylet was passed into foramen ovale.

Figure 2

The balloon catheter was introduced through the needle and navigated into Meckel's cave. The shape showed if the balloon was in the appropriate position: (a) ideal pear shape; (b) not ideal shape.

Figure 3

Kaplan-Meier plot illustrating pain-free proportion of patients after a percutaneous trigeminal ganglion balloon compression. Mean pain-free period was 15 months.