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Efficacy and safety of percutaneous balloon compression for bilateral trigeminal neuralgia: a retrospective study

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Abstract

Background

Percutaneous balloon compression (PBC) of the Gasserian ganglion is steadily gaining traction within the trigeminal neuralgia (TN) community. Bilateral trigeminal neuralgia (BTN) is a rare condition, and its treatment remains challenging. As far as we know, there are currently no research reports on the treatment outcomes of PBC for BTN.The purpose of this study is to meticulously evaluate the efficacy and safety of PBC for BTN in our medical institution.

Methods

In this retrospective study, we collected and analyzed the medical records of all patients with BTN who underwent the PBC procedure at the Department of Neurosurgery at Hebei General Hospital from July 2017 to July 2023. After undergoing PBC therapy, all patients were promptly assessed for treatment efficacy based on the modified Barrow Neurological Institute (BNI) pain intensity grading scale.

Results

All 37 patients with BTN experienced significant pain relief (BNI I-IIIb) immediately following unilateral PBC treatment. Among these patients, 25 reported relief from pain on the non-operative side, which was effectively managed with medication. Out of the 12 patients who did not experience improvement in contralateral symptoms, 11 received contralateral PBC. Out of the 48 treated sides, 47 sides (97.9%) achieved excellent pain control following a single PBC procedure. The follow-up times ranged from 2 to 62 months. At the 1-year follow-up, 94.6% of the patients maintained excellent therapeutic outcomes.Three recurrent patients underwent repeated unilateral PBC, and all of them maintained excellent pain control postoperatively. At the last follow-up, satisfaction was at 91.7% (measured using the Likert scale), with no severe complications occurring.

Conclusions

The results indicate that PBC is an effective and relatively safe method for treating BTN, offering a valuable option for pain control in these rare cases of TN.

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Authors and Affiliations

  1. Department of Neurosurgery, Hebei General Hospital, 348# Heping Road, Shijiazhuang City, 050000, Hebei Province, China

    Yinzhan Wang, Wenchang Guo, Yihui Du, Yang Li, Haowei Shi & Tao Qian

Authors
  1. Yinzhan Wang
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  2. Wenchang Guo
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  3. Yihui Du
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  4. Yang Li
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  5. Haowei Shi
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Yinzhan Wang, Wenchang Guo, Yihui Du, Yang Li, Haowei Shi and Tao Qian. The first draft of the manuscript was written by Yinzhan Wang and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Tao Qian.

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Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Consent to participate

Due to the retrospective nature of this study, informed consent was not required.

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All authors agreed with the content and that all gave explicit consent to submit and that they obtained consent from the responsible authorities at the institute/organization where the work has been carried out, before the work is submitted.

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All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.

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Comments

Interesting study from Hebei, China on unilateral percutaneous balloon compresion of the Gasserian ganglion in bilateral trigeminal neuralgia. It is noteworthy that 25/37 treated only unilateral got sufficient bilateral relief, thus underscoring a staged approach in this condition.

Carsten Reidies Bjarkam.

Aalborg, Denmark.

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Wang, Y., Guo, W., Du, Y. et al. Efficacy and safety of percutaneous balloon compression for bilateral trigeminal neuralgia: a retrospective study. Acta Neurochir 166, 51 (2024). https://doi.org/10.1007/s00701-024-05947-w

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