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

2021 ◽  
Author(s):  
Chenglong Sun ◽  
Wenhua Yu ◽  
Qiang Zhu ◽  
Quan Du
Keyword(s):  
Trigeminal Neuralgia ◽  
Therapeutic Effect ◽  
Gold Standard ◽  
Inflated Balloon ◽  
Surgical Result ◽  
Balloon Compression ◽  
Percutaneous Balloon ◽  
Percutaneous Balloon Compression ◽  
Anatomic Basis ◽  
Shape Changes

Abstract Background: The pear shape of an inflated balloon is thought to be a gold standard of a successful percutaneous balloon compression (PBC). However, neither how the balloon shape changes nor why it changes in that way (the anatomic basis) has not yet been fully described. Methods: Radiographs from over 150 percutaneous balloon compression (PBC) cases were thoroughly evaluated. We proposed a model of changing balloon shape in Meckel's cave (MC) and 70 cases were followed up over 2 years, in which therapeutic effect was measured.Results: We found that the balloon changed stereotypically in MC. The model that we proposed is consistent with the description of the structures of MC and its surroundings in the literature. The distinct pear (pear in MC) brought about a far better surgical result than other shapes (p < 0.01).Conclusion: Our study showed how and why the balloon shape changed during PBC surgery. The model provides favorable guidance for PBC surgery.

The predictive power of balloon shape and change of sensory functions on outcome of percutaneous balloon compression for trigeminal neuralgia

2010 ◽  
Vol 113 (3) ◽  
pp. 498-507 ◽  
Author(s):  
Pär Asplund ◽  
Bengt Linderoth ◽  
A. Tommy Bergenheim
Keyword(s):  
Electrical Stimulation ◽  
Pain Relief ◽  
Trigeminal Neuralgia ◽  
Therapeutic Effect ◽  
Sensory Function ◽  
Careful Study ◽  
Balloon Compression ◽  
Percutaneous Balloon ◽  
Percutaneous Balloon Compression ◽  
The Impact

Object Percutaneous balloon compression is a simple and effective treatment of trigeminal neuralgia. However, results between and within different series are varying. To further improve the results in terms of pain relief, the authors believe that a careful study of the surgical procedure is important. The object of this study was to analyze the impact of balloon shape, balloon position, balloon volume, and compression time on duration of the therapeutic effect following percutaneous balloon compression. Furthermore, they analyzed the sensory side effects associated with this treatment, and how these relate to surgical parameters. Methods Medical records and intraoperative radiographs from 87 balloon compressions were reviewed, and different surgical parameters were categorized. Univariate and multivariate analyses were performed to correlate surgical parameters to pain relief. Sensory testing with a transcutaneous electrical stimulation technique and clinical examination data were reviewed to analyze changes in sensory function. Results The balloon shape had a significant impact on time to recurrence of pain. A pear-shaped balloon resulted in a far better surgical result than a non–pear-shaped balloon (p < 0.001). The difference between a distinct and a less distinct pear shape was not significant (p = 0.14). Statistical significance was not reached for any of the other parameters in relation to duration of therapeutic effect. A pear-shaped balloon was also significantly associated with increased thresholds for percutaneous electrical stimulation in the immediate postoperative period, but the perception thresholds were normalized at the late follow-up at 3–9 months. A similar outcome was found for clinical testing with light touch and pinprick. Conclusions The authors have demonstrated that using a pear-shaped balloon when performing percutaneous balloon compression for trigeminal neuralgia results in longer pain relief than non–pear-shaped balloons. Other surgical parameters seemed less important with respect to pain relief. Balloon compression also, in many cases, results in hypesthesia.

Trochlear Nerve Palsy after Repeated Percutaneous Balloon Compression for Recurrent Trigeminal Neuralgia: Case Report and Pathogenic Considerations

Neurosurgery ◽  
2004 ◽  
Vol 54 (2) ◽  
pp. 505-509 ◽  
Author(s):  
Enrique Urculo ◽  
Roger Alfaro ◽  
Mariano Arrazola ◽  
Edgar Astudillo ◽  
Guillermo Rejas
Keyword(s):  
Trigeminal Neuralgia ◽  
Nerve Palsy ◽  
Fogarty Catheter ◽  
Trochlear Nerve ◽  
Inflated Balloon ◽  
Balloon Compression ◽  
Percutaneous Balloon ◽  
Idiopathic Trigeminal Neuralgia ◽  
Percutaneous Balloon Compression ◽  
Trochlear Nerve Palsy

Abstract OBJECTIVE AND IMPORTANCE Repeated percutaneous balloon compression for the treatment of idiopathic trigeminal neuralgia is infrequent. When a second procedure is performed, the outcome is unknown. A patient developed an isolated trochlear nerve palsy after undergoing percutaneous trigeminal ganglion balloon compression for a second time. The mechanism of diplopia and the complications associated with this technique were studied. CLINICAL PRESENTATION The patient was a 67-year-old woman with a history of medically refractory idiopathic trigeminal neuralgia involving all three divisions of the right trigeminal nerve. INTERVENTION Percutaneous balloon compression was performed. Despite initial total relief from pain without complications, the patient again displayed manifestations of trigeminal neuralgia 3 months after the procedure. The pain disappeared after she underwent a second balloon compression procedure, but she developed an isolated trochlear nerve palsy, which spontaneously resolved in 2 months. CONCLUSION Isolated trochlear nerve palsy is a rare and reversible complication after percutaneous balloon compression for trigeminal neuralgia. This case illustrates that the mechanism of injury to the fourth nerve is the result of an erroneous technique: excessive penetration of the Fogarty catheter in Meckel's cave beyond the porus trigemini and compression of the cisternal segment of the trochlear nerve when the inflated balloon is pushed against the tentorium.

scholarly journals A prospective study of 39 patients with trigeminal neuralgia treated with percutaneous balloon compression

2011 ◽  
Vol 69 (2a) ◽  
pp. 221-226 ◽  
Author(s):  
Wuilker Knoner Campos ◽  
Marcelo N. Linhares
Keyword(s):  
Trigeminal Neuralgia ◽  
Female Gender ◽  
Safe Procedure ◽  
Approval Ratings ◽  
Balloon Compression ◽  
Percutaneous Balloon ◽  
Percutaneous Balloon Compression ◽  
The Face ◽  
The Right ◽  
A Prospective Study

OBJECTIVE: Trigeminal neuralgia is the most common facial pain. It may be treated with percutaneous balloon compression (PBC), which is considered to be a safe and efficient procedure. The purpose of this study was to review our results with PBC and to assess the factors influencing the outcome. METHOD: A multivariate analysis was used to study 39 patients during a 50-month postoperative period. RESULTS: There was predominance of the female gender (54%), the right side of the face (84%) and V2V3 roots of trigeminal nerve (33%). The mean age was 62.3 years. No major complications or deaths occurred. Among all variables, postoperative hypoesthesia was the single prognostic factor capable of positively influencing the results (p=0.02). Most patients (80%) were pain-free after 50 months with a 90% satisfaction rate. CONCLUSION: PBC was a safe procedure with low morbidity, no mortality, high approval ratings, and was an important improving on patients' quality of life.

TM2-4 Long term outcome of percutaneous balloon compression for trigeminal neuralgia

2019 ◽  
Vol 90 (3) ◽  
pp. e13.3-e12 ◽  
Author(s):  
D Bhargava ◽  
P Cristaldi ◽  
P Franceschini ◽  
P Eldridge ◽  
J Osman-Farah
Keyword(s):  
Trigeminal Neuralgia ◽  
Symptom Relief ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Balloon Compression ◽  
Percutaneous Balloon ◽  
Retrospective Audit ◽  
Percutaneous Balloon Compression ◽  
Anaesthesia Dolorosa

ObjectivesPercutaneous balloon compression (PBC) can be offered to medically refractory patients with trigeminal neuralgia who are unsuitable for microvascular decompression. Its associated with up to 4% risk of anaesthesia dolorosa which increases with duration and severity of compression and is more common with repeat procedures. We audited our outcomes for this procedure over last 7 years.DesignRetrospective audit of prospectively collected data.SubjectsAll patients undergoing PBC at our centre.MethodsTheatre and radiology records reviewed to identify patients. Case notes and radiology reviewed for history, diagnosis, details of procedure, immediate symptom relief, complications, further procedures and last follow up. Descriptive, comparative Kaplan Meir analysis undertaken.ResultsTotal 93 patients (4 b/l), 165 procedures. Average follow up 36 months. 24 patients had MS, 17 patients had atypical pain. All except 4 patients had good immediate pain relief. No patient developed anaesthesia dolorosa, 2 patients had transient diplopia, 1 maxillary hematoma and 1 infection. 56 experienced recurrence, 43 needed further surgical intervention. 25 PBC twice, 11 thrice, 4 four times and 1 five times. Average time to first recurrence=32 months. 85% pain free at 1 year and 70% at 2 years.ConclusionsPBC is an effective procedure. With conservative approach, this procedure can be safely repeated.

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