Long‐term recurrence‐free survival and complications of percutaneous balloon compression and radiofrequency thermocoagulation of Gasserian ganglion for trigeminal neuralgia: A retrospective study of 1313 cases

Zheng, Shuyue; Yuan, Rong; Ni, Jiaxiang; Liu, Hongfu; Yang, Yucheng; Zhang, Shusheng; Li, Juanhong

doi:10.1111/papr.13114

Cited by 14 publications

(6 citation statements)

References 35 publications

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“…This is an important imaging indication to ensure the efficacy of PBC, and balloon pressure and compression time are important factors affecting the postoperative outcome ( 24 ). However, there is no uniform standard for balloon pressure and balloon compression time ( 25 ), which still needs to be explored.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous ballon compression for recurrent TN —a retrospective study of 33 cases

Feng,

Zhang,

et al. 2023

Front. Neurol.

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ObjectiveTo investigate the clinical efficacy of percutaneous microballoon compression in the treatment of recurrent TN.MethodsThis retrospective study included 33 patients who underwent percutaneous microballoon compression for the treatment of recurrent TN from March 2019 to May 2022. Postoperative pain recurrence and facial numbness were assessed according to the Barrow Neurological Institute (BNI) pain score. Patients’ anxiety and sleep status during follow-up were assessed according to the Self-rating Anxiety Scale (SAS) and Pittsburgh Sleep Quality Index (PSQI).ResultsAll patients (33 cases) were followed up for 12–38 months, with an average follow-up time of 23 months. On postoperative day 1, 31 patients (93.9%) reported no pain, and 2 patients were given drug treatment for pain relief, The total efficacy was 93.9%. Moreover, 2 patients (6.1%) reported significant pain relief 2 weeks postoperatively. There are many complications during and after PBC. The incidence of the trigeminocardiac reflex (TCR) during surgery was 100%, and the incidence of facial numbness, masseter muscle weakness, labial herpes and headache was 97, 60.6, 12.1 and 3%. No patient experienced severe facial numbness, hearing impairment, diplopia, injury to cranial nerves, Meningitis, intracranial haemorrhage or keratitis. 1 patient had recurrence of pain at 6 months post-op, which was relieved by oral medication. 81.8% suffered from anxiety and 54.5% had poor sleep quality before surgery. After the period of PBC, SAS and PSQI scores decreased continuously. There were significant improvements in anxiety and sleep status postoperatively compared with preoperatively.ConclusionPBC is a safe and effective option for the treatment of recurrent TN. The arduous and demanding nature of the clinical course subjects the patient to severe pain, mental, and physical stress. Thankfully, it significantly improves the symptoms of anxiety, depression, and sleep quality.

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Section: Discussionmentioning

confidence: 99%

Percutaneous ballon compression for recurrent TN —a retrospective study of 33 cases

Feng,

Zhang,

et al. 2023

Front. Neurol.

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“…9 Long-term clinical practice has shown that if the quality of PBC surgery and effective "pear formation" is ensured, then better pain relief rates and lower recurrence rates can be obtained. [10][11][12] Traditional PBC surgery is performed under the guidance of X-ray or CT, [13][14][15][16][17] although lateral X-ray alone can only provide two-dimensional non-sectional images and cannot fully display the complex skull base bony structure and foramen ovale. However, using various improved CT-guided techniques 18,19 or surgery under electromagnetic navigation 20,21 still relies on the operator's free-hand operation and lacks the constraints of a fixed frame.…”

Section: Discussionmentioning

confidence: 99%

Robot-Assisted Percutaneous Balloon Compression in Elderly Patients with Trigeminal Neuralgia

Tan¹,

Li²,

Peng³

et al. 2023

JPR

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Objective To investigate the clinical effects of percutaneous balloon compression (PBC) for trigeminal neuralgia in elderly patients with the assistance of a neurosurgical navigation and positioning planning system (referred to hereafter as the robot). Methods We performed a retrospective analysis of 11 patients with trigeminal neuralgia. Preoperative TOF MRA, T2WI-SPACE, and thin-slice CT scans were performed, and the volume of Meckel’s Cave was calculated by multi-modal image fusion on a workstation. Surgical planning involved two paths. Path A was the actual puncture path, the target point was the anterior inner quadrant of the inner opening of the foramen ovale; Path B represented a virtual path for measurement, and was used to plan the depth of balloon placement. The foramen ovale puncture for path A was completed under the guidance of a robotic arm adapter, while path B was completed under lateral X-ray fluoroscopy with a DSA machine. The balloon was placed at a predetermined depth, and filled to a “pear” shape to complete the operation. Preliminary follow-up results were obtained by considering VAS score and BNI classification. Results The foramen ovale was successfully punctured in all 11 patients and entered Meckel’s Cave, the balloon was then filled to create a “pear shape”. Immediate complete healing was achieved in 10 patients and delayed healing was achieved in one patient by the 5th postoperative day. No serious complications were identified that were related to surgery, and over a follow-up time of 1–12 months, there was no recurrence of pain, and a BNI numbness grade of 2–3 points. The appropriate ratio of the balloon inflated volume to the preoperative Meckel’s Cave volume was approximately 1.7. Conclusion Preliminary clinical application and short-term follow-up showed that robot-assisted PBC surgery is a safe and effective surgical method for elderly patients with trigeminal neuralgia.

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“…Although the procedure can be easily done by experienced doctors, it requires a long learning cycle[ 4 ]. What’s more, this procedure could result in some severe complications, which are usually related to foramen ovale puncture [ 5 – 7 ]. For this, many devices and techniques have been used for it [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

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

Sun

et al. 2023

BMC Neurol

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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.

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Long‐term recurrence‐free survival and complications of percutaneous balloon compression and radiofrequency thermocoagulation of Gasserian ganglion for trigeminal neuralgia: A retrospective study of 1313 cases

Cited by 14 publications

References 35 publications

Percutaneous ballon compression for recurrent TN —a retrospective study of 33 cases

Percutaneous ballon compression for recurrent TN —a retrospective study of 33 cases

Robot-Assisted Percutaneous Balloon Compression in Elderly Patients with Trigeminal Neuralgia

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

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