Percutaneous trigeminal ganglion balloon compression for treatment of trigeminal neuralgia, part II: Results related to compression duration

OBJECTIVE The purpose of this study is to find out how different compression time affects the results of percutaneous trigeminal ganglion compression for treatment of trigeminal neuralgia. METHODS This study includes 80 patients with intractable third-branch trigeminal (V3) neuralgia who had received percutaneous trigeminal ganglion balloon compression. All the patients received same treatment protocol except for the duration of compression. Group 1 patients received 60-second and Group 2 patients received 180-second compression. A computerized pressure recording system was used for pressure monitoring and analysis. RESULTS Both groups had 100% immediate pain relief and all patients experienced mastication weakness immediately after the procedure. The facial numbness was severe in Group 2 in the first trigeminal (V1) distribution (p < 0.05) but not in the second or third trigeminal (V2, 3) distribution (p > 0.05) in the immediate period after the operation. The recurrence rate in the first year follow-up was higher in Group 1 (5%) than in Group 2 (2.5%) but did not reach the statistical difference (p > 0.05). At 1 year follow-up after the procedure, Group 1 had lower incidence of facial numbness over all trigeminal distribution (V1,2,3) than Group 2 (p < 0.05) mastication weakness all recovered during the first year follow-up. CONCLUSIONS With accurate monitoring of the balloon pressure during the percutaneous trigeminal ganglion compression, it was found that the shorter duration of compression had less side effect. At one year follow-up, the incidence of recurrence rate was slightly higher in the patients who received 60-second compression than in those who received 180-second compression, but there was no significant statistical difference. Whether patients with first or second branch of trigeminal neuralgia require longer compression duration needs further study. (C) 2003 Elsevier Inc. All rights reserved.