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. 2022 Feb 14:9:843982.
doi: 10.3389/fsurg.2022.843982. eCollection 2022.

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

Hui Wang  1 , Chunhui Chen  1 , Da Chen  1 , Fengsheng Li  1 , Shan Hu  1 , Wenqian Ding  1 , Jun Wang  1 , Wanghua Chen  1
Affiliations

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

Hui Wang et al. Front Surg. .

Abstract

Purpose: To summarize the technical points and clinical effects of percutaneous balloon compression (PBC) in the treatment of primary trigeminal neuralgia.

Methods: The 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.

Results: All 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%).

Conclusion: PBC 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.

Keywords: clinical effect; minimally invasive surgical; pain; percutaneous balloon compression; trigeminal neuralgia.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
(A) 64-slice CT skull reconstruction was performed before surgery to check the direction and size of the foramen ovale; (B) Determine the direction of the patient's puncture.
Figure 2
Figure 2
(A–C) After the puncture was in place during the operation, the balloon was filled, and the puncture point had to be inside Meckel's cave and formed an effective “pear” shape.
Figure 3
Figure 3
(A) When the posterior margin of the upper palate, temporomandibular joint and external auditory canal overlap (shown by arrow), it was considered a standard lateral position; (B) After the puncture needle pierces the dura mater of foramen ovale, it needs to be kept outside the skull to avoid further penetration, and the balloon will form an “inverted pear” shape after filling.
Figure 4
Figure 4
The puncture process was guided under the direction of DSA.
See this image and copyright information in PMC

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