The Transformation of the Balloon Shape in Percutaneous Balloon Compression for Trigeminal Neuralgia

Sun, Cheng; Zheng, Wenhao; Zhu, Quing; Du, Qiang; Wang, Yu

doi:10.2147/jpr.s343783

Cited by 16 publications

(9 citation statements)

References 18 publications

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“…Although PBC is widely used in the treatment of TN, some unavoidable complications that may affect the nal treatment outcome have also been reported [29]. In the study, The incidence of TCR(trigeminocardiac re ex) during the operation was 100%.…”

Section: Disscutionmentioning

confidence: 83%

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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Section: Disscutionmentioning

confidence: 83%

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

Feng,

Zhang,

et al. 2023

Preprint

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“…The Meckel’s cave is flat before it is filled with balloon, pear-shaped balloon indicates enough pressure in the balloon so the head forms a small protrusion protruding from the porus trigeminus [ 16 ]. In addition to typical pear shape, the balloon may also form pear-like, oval, round, irregular, dumbbell shapes [ 11 , 17 , 18 ]. In our study, all the balloons formed pear shape with or without position adjustments of the catheter.…”

Section: Discussionmentioning

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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“…If the balloon completely slides out of the cavity, only an original oval shape can form outside the cavity. 39 , 41 Whether “dumbbell” shaped, oval shaped, or inverted “pear” shaped balloon, the pain relief is worse than that of the “pear” shaped balloon. Some balloon shapes, such as “dumbbell” shaped balloons, can also cause some degree of postoperative pain relief, as well as effective compression on the trigeminal ganglion.…”

Section: The Key Point—shape and Morphological Changes Of The Balloonmentioning

confidence: 99%

“… 25 , 48 The size of the foramen ovale is also correlated with the balloon pressure, and a narrow foramen ovale is often associated with lower balloon pressure. 41 , 49 Balloon pressure and volume can be used as an auxiliary reference index. Of note, the intraoperative pressure can be recorded to build the pressure model.…”

Section: The Current Balloon Compression Time and Pressurementioning

confidence: 99%

The Focus and New Progress of Percutaneous Balloon Compression for the Treatment of Trigeminal Neuralgia

Xia¹,

Yu²,

Min³

et al. 2022

JPR

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Trigeminal neuralgia is a condition confined to the trigeminal nerve, causing one or more branches of facial nerve pain. Surgical treatment options for trigeminal neuralgia include microvascular decompression(MVD), percutaneous balloon compression (PBC), radiofrequency thermocoagulation(RF), percutaneous retrogasserian glycerol rhizotomy(PRGR), gamma knife, etc. Of these treatments, PBC is increasingly being used by clinicians for trigeminal neuralgia. PBC is a simple surgical operation performed to treat trigeminal neuralgia. Owing to its advantages, PBC is favored by many clinicians. In this study, we aimed to emphasize the need to analyze the shape of the balloon, position, compression time, and pressure, as these factors can affect the efficacy of PBC. The relief of pain by balloon compression is related to the shape of the balloon on X-ray, which is the key to the operation. Owing to continued progress and advances in current imaging technologies, clinicians revealed that the precise positioning of the foramen ovale is no longer an intraoperative problem. Instead, the anatomy of Meckel's cave and the shape of the balloon must be the focus to achieve the best treatment effect. For clinicians, PBC is simple and is associated with a short operation time. PBC also has other advantages, such as low cost and immediate postoperative pain relief. The recurrence rate of pain post-PBC is low, despite the occurrence of facial numbness post-op. However, this side effect is reversible and does not affect daily life of the patient. In fact, the patient can be discharged 1-2 days after surgery. Overall, PBC can be considered as one of the preferred surgical methods for the treatment of primary trigeminal neuralgia. In this paper, we explain the main points of PBC operation in detail in terms of Meckel's cave, surgical procedure, complications, discussion of the focus and new progress, etc.

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The Transformation of the Balloon Shape in Percutaneous Balloon Compression for Trigeminal Neuralgia

Cited by 16 publications

References 18 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 for trigeminal neuralgia- preliminary experiences

The Focus and New Progress of Percutaneous Balloon Compression for the Treatment of Trigeminal Neuralgia

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