The extracapsular capsule phenomenon of percutaneous balloon compression provides adequate compression of the third branch of the trigeminal nerve: a retrospective study

• Published in: Neurosurgical review 2024-08, Vol.47 (1), p.499, Article 499
• Main Authors: Fu, Lijun, Liu, Zuying, Bu, Huilian, Lu, Zhongyuan, Kong, Cunlong, Wang, Tao, Ma, Letian, Wen, Yuanyuan, Liu, Qingying, Wang, Zhongyu, Wang, Jian, Fan, Xiaochong
• Format: Article
• Language: English
• Subjects: Aged; Case-Control Studies; Female; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Neurosurgery; Retrospective Studies; Treatment Outcome; Trigeminal Nerve - surgery; Trigeminal Neuralgia - surgery; Trigeminal Neuralgia - therapy
• ISSN: 1437-2320; 1437-2320
• DOI: 10.1007/s10143-024-02711-7

Background Percutaneous balloon compression (PBC) is an effective, low-cost, and simple treatment for primary trigeminal neuralgia (TN). However, PBC has poor efficacy and no better solution for the third branch (V3) of TN. Methods Clinical data of 52 patients with trigeminal neuralgia treated with PBC were retrospectively analyzed. Postoperative numbness of the patient was evaluated by facial numbness at the Barrow Neurological Institute (BNI-N). The main observation was the incidence of higher numbness in the V3 than in the other two branches or equally strong numbness in the three branches in the immediate postoperative period. Results The efficacy values in the pear-shaped balloon group at the first postoperative day (T 1 ), the first month (T 2 ), in the third month (T 3 ), and the sixth month (T 4 ) were 96.7%, 93.3%, 93.3%, and 90%, respectively, and 1 patient (3.3%) had recurrence. The efficacy value for the extracapsular capsule group was 95.5% at all times and there were no patients with recurrence within 6 months after surgery. In the immediate postoperative period, the effective compression rate of V3 in the pear-shaped balloon group was 43.3%, and 86.4% in the extracapsular capsule group ( P  = 0.020). At six months of follow-up, the effective compression rate of V3 was higher in the extracapsular capsule group than in the pear-shaped balloon group. Conclusions The riveted structure of the extracapsular capsule can effectively compress V3, thus performing PBC with a balloon shaped as an extracapsular capsule is a new, effective, and safe treatment option for TN V3. Trial registration ClinicalTrials.gov ChiCTR2300067313.