A 20-year review of percutaneous balloon compression of the trigeminal ganglion

2001 ◽  
Vol 94 (6) ◽  
pp. 913-917 ◽  
Author(s):  
David J. Skirving ◽  
Noel G. Dan
Keyword(s):  
Trigeminal Neuralgia ◽  
Trigeminal Ganglion ◽  
Complication Rates ◽  
Entire Study ◽  
Content Type ◽  
Balloon Compression ◽  
Percutaneous Balloon ◽  
Percutaneous Balloon Compression ◽  
Fine Print

Object. The aim of this study was to investigate outcomes and complication rates associated with percutaneous balloon compression (PBC) of the trigeminal ganglion over a long follow-up period. Methods. This retrospective review was conducted in 496 patients with typical symptoms of unilateral trigeminal neuralgia who underwent 531 PBCs of the trigeminal ganglion between 1980 and 1999. The mean length of follow up was 10.7 years. The treatment used was a modification of that first described by Mullan and Lichtor in 1983. There were nine technical failures. Of the 522 successful procedures, prompt pain relief ensued in all patients except one. Recurrence of pain was found in 95 patients (19.2%) within 5 years and in 158 patients (31.9%) over the entire study period. Symptomatic dysesthesias occurred in 19 patients (3.8%), but corneal anesthesia and anesthesia dolorosa did not. Conclusions. In this review the authors present data on the largest cohort of patients with the longest follow up for this procedure in the current literature. The balance between the recurrence rate and troublesome sensory complications achieved in this series is favorable when compared with previously published studies on outcomes of PBC and the two alternative percutaneous methods, radiofrequency thermocoagulation and glycerol rhizolysis. The PBC procedure has additional advantages in that it is relatively straightforward and quick, and can be performed during a brief period of general anesthesia with no discomfort to the patient. This makes it an attractive first choice in the treatment of trigeminal neuralgia.

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.

A 10-year follow-up review of percutaneous microcompression of the trigeminal ganglion

1990 ◽  
Vol 72 (1) ◽  
pp. 49-54 ◽  
Author(s):  
Terry Lichtor ◽  
John F. Mullan
Keyword(s):  
Trigeminal Neuralgia ◽  
General Anesthesia ◽  
Trigeminal Ganglion ◽  
Cerebral Damage ◽  
Content Type ◽  
Fine Print

✓ Percutaneous microcompression of the trigeminal ganglion for the relief of trigeminal neuralgia is a technically simple, nonpainful procedure, carried out under brief general anesthesia. One hundred patients treated by this method have been followed for 1 to 10 years; treatment has been technically successful in 97% of cases. Relief persisted at five years in 80%, and it is estimated that at 10 years the figure will be 70%. There were no deaths, no cerebral damage, no keratitis, and no analgesia dolorosa; 4% of the patients reported dysesthesia.

Percutaneous microcompression of the trigeminal ganglion for trigeminal neuralgia

1983 ◽  
Vol 59 (6) ◽  
pp. 1007-1012 ◽  
Author(s):  
Sean Mullan ◽  
Terry Lichtor
Keyword(s):  
Trigeminal Neuralgia ◽  
General Anesthesia ◽  
Recurrence Rate ◽  
Trigeminal Ganglion ◽  
Balloon Catheter ◽  
Morbidity Rate ◽  
Content Type ◽  
Biplane Fluoroscopy ◽  
Fine Print

✓ Fifty patients were treated for trigeminal neuralgia by percutaneous microcompression of the trigeminal ganglion. A No. 4 Fogarty balloon catheter was inserted under brief general anesthesia, using biplane fluoroscopy. This procedure is essentially a percutaneous simplication of the older Taarnhøj-Sheldon-Pudenz operation. The follow-up period ranged from 0.5 to 4.5 years. Pain recurred in 12% of cases during that time, and it is anticipated that within 5 years the recurrence rate will reach 20%, which is approximately the same rate as for the alternative established procedures. The advantages of this technique are freedom from discomfort on the part of the patient, a remarkable ease of performance on the part of the operator, absence of associated mortality, and a minimal morbidity rate.

Comparison of percutaneous balloon compression and glycerol rhizotomy for the treatment of trigeminal neuralgia

2010 ◽  
Vol 113 (3) ◽  
pp. 486-492 ◽  
Author(s):  
Konstantinos Kouzounias ◽  
Göran Lind ◽  
Gastón Schechtmann ◽  
Jaleh Winter ◽  
Bengt Linderoth
Keyword(s):  
Trigeminal Neuralgia ◽  
Treatment Modalities ◽  
Recurrence Time ◽  
Chi Square ◽  
Balloon Compression ◽  
Duration Of Effect ◽  
Percutaneous Balloon ◽  
Percutaneous Balloon Compression ◽  
Chi Square Test

Object The aim of this study was to compare percutaneous balloon compression (PBC) and percutaneous retrogasserian glycerol rhizotomy (PRGR) in terms of effectiveness, complications, and technical aspects. Methods Sixty-six consecutive PBC procedures were performed in 45 patients between January 2004 and December 2008, and 120 PRGR attempts were performed in 101 patients between January 2006 and December 2008. The PRGR procedures were not completed due to technical reasons in 19 cases. Five patients in the Balloon Compression Group and 9 patients in the Glycerol Group were lost to follow-up and were excluded from the study. The medical records and the intraoperative fluoroscopic images from the remaining cases were retrospectively examined, and the follow-up was completed with telephone contact, when necessary. The 2 groups were compared in terms of initial effect, duration of effect, and rates of complications as well as severity and type of complications. Results The rates for immediate pain relief were 87% for patients treated with glycerol injection and 85% for patients treated with balloon compression. The Kaplan-Meier plots for the 2 treatment modalities were similar. The 50% recurrence time was 21 months for the balloon procedure and 16 months for the glycerol procedure. When the groups were broken down by the “previous operations” criterion, the 50% recurrence time was 24 months for the Glycerol First Procedure Group, 6 months for the Balloon First Procedure Group, 8 months for the Glycerol Previous Procedures Group, and 21 months for the Balloon Previous Procedures Group. The rates of complications (excluding numbness) were 11% for PRGR and 23% for PBC, and this difference was statistically significant (chi-square test, p = 0.04). Conclusions Both PRGR and PBC are effective techniques for the treatment of trigeminal neuralgia, with PRGR presenting some advantages in terms of milder and fewer complications and allowing lighter anesthesia without compromise of analgesia. For these reasons the authors consider PRGR as the first option for the treatment of trigeminal neuralgia in patients who are not suitable candidates or are not willing to undergo microvascular decompression, while PBC is reserved for patients in whom the effect of PRGR has proven to be short or difficult to repeat due to cisternal fibrosis.

Percutaneous trigeminal ganglion compression for trigeminal neuralgia

1989 ◽  
Vol 70 (6) ◽  
pp. 900-904 ◽  
Author(s):  
Jeffrey A. Brown ◽  
Mark C. Preul
Keyword(s):  
Trigeminal Neuralgia ◽  
Trigeminal Ganglion ◽  
Nerve Palsy ◽  
Content Type ◽  
Root Section ◽  
Trigeminal Nerve Root ◽  
Corneal Reflex ◽  
Fine Print ◽  
Sixth Nerve

✓ Between 1983 and 1988, a percutaneous trigeminal ganglion compression (PTGC) procedure for trigeminal neuralgia was performed on 22 patients. All patients were initially relieved of their pain. There were three recurrences (14%); two of these patients underwent a second PTGC procedure and one a partial trigeminal nerve root section. Follow-up examination 3 to 53 months after the procedure showed that all patients were free of pain. Morbidity included persistent minor hypesthesia in five patients, persistent minor dysesthesias in three, persistent minor weakness in three, aseptic meningitis in one, transient sixth nerve palsy in one, and transient otalgia in three. None of the patients had either anesthesia dolorosa or an absent corneal reflex.

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