Percutaneous Rhizotomy of the Gasserian Ganglion in Patients With Mass Lesion–Associated Trigeminal Neuralgia: A Case Series

Petitt, Jordan C.; Murayi, Roger; Potter, Tamia; Ahorukomeye, Peter; Jarmula, Jakub; Recinos, Pablo F.; Barnett, Gene H.; Kshettry, Varun R.

doi:10.1227/ons.0000000000000707

Cited by 2 publications

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References 34 publications

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“…This may be associated with improvements in surgical techniques. Correct needle insertion at the foramen ovale and balloon insertion in Meckel’s lumen are two important steps in PBC ( 23 ). Using imaging techniques, we can determine if the needle accurately reaches the foramen ovale and is in the correct position.…”

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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show abstract

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

Feng,

Zhang,

et al. 2023

Preprint

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Objective To investigate the clinical efficacy of percutaneous microballoon compression in the treatment of recurrent TN. Methods The retrospective study including 33 patients who underwent percutaneous microballoon compression for the treatment of recurrent TN from March 2019 to May 2022. There were 11 male and 22 females with a mean age of 70.9 years. The Pain side includes left side in 10 cases and right side in 23 cases. The duration of illness ranged from 2 to 20 years, with a median duration of illness of 5 years. The interval between this operation and the last operation was (12–80) months, with an average of 36.6 ± 18.6 months. 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 self-rating anxiety scale (SAS) and Pittsburgh sleep quality index (PSQI). Results All patients (33 cases) were followed up for 12–38 months, with an average follow-up time of 23 months. The pain relief rate 24 hours after surgery was 93.9%, and 2 patients with pain grade III were given drug treatment for pain relief. There were 32 cases of facial numbness in the affected side, and the facial numbnessnumbness grade of BIN at 12 months was II or less. Twenty patients developed varying degrees of masticatory muscle weakness, which gradually recovered after 2 to 10 months. Four patients developed perioral herpes simplex and were cured after giving antiviral drugs. One patient developed ocular discomfort, which improved after 2 weeks. One patient had recurrence of pain at 6 months, which was relieved by oral medication. There were no serious complications such as hearing impairment, intracranial hemorrhage and keratitis. According to the pain score of the Institute of Neurology (BNI), the preoperative pain score was 3.00 and 0.21 ± 0.60 at the last follow-up, and there was a significant difference in pain scores at different periods (P < 0.001). Preoperative moderate to severe anxiety was 81.8% (27/33), and moderate to severe anxiety was 15.2% (5/33) at the last follow-up, and the differences were statistically significant compared with preoperative (P < 0.001). Preoperative sleep quality was poor in 54.5% (18/33). The number of sleep at the last follow-up was 9.1% (3/33) worse, and the differences were statistically significant compared with those before surgery (P < 0.001). Poor sleep quality was observed in 54.5% (18/33) before surgery. The difference in the number of sleep at the last follow-up was 9.1% (3/33), and the differences were statistically significant compared with those before surgery (P < 0.001). Conclusion PBC is a practical and effective method for the treatment of recurrent TN. It not only has obvious analgesic effect, but also improves the anxiety and sleep disorder of patients. The rich experience of surgeons and meticulous intraoperative operation help to reduce the related complications and improve the clinical efficacy.

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Percutaneous Rhizotomy of the Gasserian Ganglion in Patients With Mass Lesion–Associated Trigeminal Neuralgia: A Case Series

Cited by 2 publications

References 34 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

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

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