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

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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.

Article Information

Contributor Notes

Address reprint requests to: Noel Dan, F.R.A.C.S., Specialist Medical Centre, 235 New South Head Road, Edgecliff NSW 2027, Australia. email: davidskirving@hotmail.com.

© AANS, except where prohibited by US copyright law.

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References
  • 1.

    Abdennebi BMahfouf LNedjahi T: Long-term results of percutaneous compression of the gasserian ganglion in trigeminal neuralgia (series of 200 patients). Stereotact Funct Neurosurg 68:1901951997Abdennebi B Mahfouf L Nedjahi T: Long-term results of percutaneous compression of the gasserian ganglion in trigeminal neuralgia (series of 200 patients). Stereotact Funct Neurosurg 68:190–195 1997

    • Search Google Scholar
    • Export Citation
  • 2.

    Apfelbaum RI: A comparison of percutaneous radiofrequency trigeminal neurolysis and microvascular decompression of the trigeminal nerve for the treatment of tic douloureux. Neurosurgery 1:16211977Apfelbaum RI: A comparison of percutaneous radiofrequency trigeminal neurolysis and microvascular decompression of the trigeminal nerve for the treatment of tic douloureux. Neurosurgery 1:16–21 1977

    • Search Google Scholar
    • Export Citation
  • 3.

    Belber CJRak RA: Balloon compression rhizolysis in the surgical management of trigeminal neuralgia. Neurosurgery 20:9089131987Belber CJ Rak RA: Balloon compression rhizolysis in the surgical management of trigeminal neuralgia. Neurosurgery 20:908–913 1987

    • Search Google Scholar
    • Export Citation
  • 4.

    Broggi GFranzini ALasio Get al: Long-term results of percutaneous retrogasserian thermorhizotomy for “essential” trigeminal neuralgia: Considerations in 1000 consecutive patients. Neurosurgery 26:7837871990Broggi G Franzini A Lasio G et al: Long-term results of percutaneous retrogasserian thermorhizotomy for “essential” trigeminal neuralgia: Considerations in 1000 consecutive patients. Neurosurgery 26:783–787 1990

    • Search Google Scholar
    • Export Citation
  • 5.

    Brown JAGouda JJ: Percutaneous balloon compression of the trigeminal nerve. Neurosurg Clin North Am 8:53621997Brown JA Gouda JJ: Percutaneous balloon compression of the trigeminal nerve. Neurosurg Clin North Am 8:53–62 1997

    • Search Google Scholar
    • Export Citation
  • 6.

    Brown JAPreul MC: Percutaneous trigeminal ganglion compression for trigeminal neuralgia. Experience in 22 patients and review of the literature. J Neurosurg 70:9009041989Brown JA Preul MC: Percutaneous trigeminal ganglion compression for trigeminal neuralgia. Experience in 22 patients and review of the literature. J Neurosurg 70:900–904 1989

    • Search Google Scholar
    • Export Citation
  • 7.

    Burchiel KJ: Percutaneous retrogasserian glycerol rhizolysis in the management of trigeminal neuralgia. J Neurosurg 69:3613661988Burchiel KJ: Percutaneous retrogasserian glycerol rhizolysis in the management of trigeminal neuralgia. J Neurosurg 69:361–366 1988

    • Search Google Scholar
    • Export Citation
  • 8.

    Burchiel KJSteege TDHowe JFet al: Comparison of percutaneous radiofrequency gangliolysis and microvascular decompression for the surgical management of tic douloureux. Neurosurgery 9:1111191981Burchiel KJ Steege TD Howe JF et al: Comparison of percutaneous radiofrequency gangliolysis and microvascular decompression for the surgical management of tic douloureux. Neurosurgery 9:111–119 1981

    • Search Google Scholar
    • Export Citation
  • 9.

    Correa CFTeixeira MJ: Balloon compression of the Gasserian ganglion for the treatment of trigeminal neuralgia. Stereotact Funct Neurosurg 71:83891998Correa CF Teixeira MJ: Balloon compression of the Gasserian ganglion for the treatment of trigeminal neuralgia. Stereotact Funct Neurosurg 71:83–89 1998

    • Search Google Scholar
    • Export Citation
  • 10.

    Dieckmann GBockermann VHeyer Cet al: Five-and-ahalf years' experience with percutaneous retrogasserian glycerol rhizotomy in treatment of trigeminal neuralgia. Appl Neurophysiol 50:4014131987Dieckmann G Bockermann V Heyer C et al: Five-and-ahalf years' experience with percutaneous retrogasserian glycerol rhizotomy in treatment of trigeminal neuralgia. Appl Neurophysiol 50:401–413 1987

    • Search Google Scholar
    • Export Citation
  • 11.

    Ferguson GGPeerless BSJGirvin JP: Trigeminal neuralgia: a comparison of the results of percutaneous rhizotomy and microvascular decompression. Can J Neurol Sci 8:2072141981Ferguson GG Peerless BSJ Girvin JP: Trigeminal neuralgia: a comparison of the results of percutaneous rhizotomy and microvascular decompression. Can J Neurol Sci 8:207–214 1981

    • Search Google Scholar
    • Export Citation
  • 12.

    Fraioli BEsposito VGuidetti Bet al: Treatment of trigeminal neuralgia by thermocoagulation, glycerolization and percutaneous compression of the gasserian ganglion and/or retrogasserian rootlets: long-term results and therapeutic protocol. Neurosurgery 24:2392451989Fraioli B Esposito V Guidetti B et al: Treatment of trigeminal neuralgia by thermocoagulation glycerolization and percutaneous compression of the gasserian ganglion and/or retrogasserian rootlets: long-term results and therapeutic protocol. Neurosurgery 24:239–245 1989

    • Search Google Scholar
    • Export Citation
  • 13.

    Frank FFabrizi AP: Percutaneous surgical treatment of trigeminal neuralgia. Acta Neurochir 97:1281301989Frank F Fabrizi AP: Percutaneous surgical treatment of trigeminal neuralgia. Acta Neurochir 97:128–130 1989

    • Search Google Scholar
    • Export Citation
  • 14.

    Lichtor TMullan JF: A 10 year-follow-up review of percutaneous microcompression of the trigeminal ganglion. J Neurosurg 72:49541990Lichtor T Mullan JF: A 10 year-follow-up review of percutaneous microcompression of the trigeminal ganglion. J Neurosurg 72:49–54 1990

    • Search Google Scholar
    • Export Citation
  • 15.

    Lobato RDRivas JJSarabia Ret al: Percutaneous microcompression of the gasserian ganglion for trigeminal neuralgia. J Neurosurg 72:5465531990Lobato RD Rivas JJ Sarabia R et al: Percutaneous microcompression of the gasserian ganglion for trigeminal neuralgia. J Neurosurg 72:546–553 1990

    • Search Google Scholar
    • Export Citation
  • 16.

    Lunsford LD: Percutaneous retrogasserian glycerol rhizotomy in Rovit RLMurali RJannetta PJ (eds): Trigeminal Neuralgia. Baltimore: Williams & Wilkins1990 pp 145164Lunsford LD: Percutaneous retrogasserian glycerol rhizotomy in Rovit RL Murali R Jannetta PJ (eds): Trigeminal Neuralgia. Baltimore: Williams & Wilkins 1990 pp 145–164

    • Search Google Scholar
    • Export Citation
  • 17.

    Meglio MCioni BMoles Aet al: Microvascular decompression versus percutaneous procedures for typical trigeminal neuralgia: personal experience. Stereotact Funct Neurosurg 54/55:76791990Meglio M Cioni B Moles A et al: Microvascular decompression versus percutaneous procedures for typical trigeminal neuralgia: personal experience. Stereotact Funct Neurosurg 54/55:76–79 1990

    • Search Google Scholar
    • Export Citation
  • 18.

    Menzel JPiotrowski WPenzholz H: Long-term results of Gasserian ganglion electrocoagulation. J Neurosurg 42:1401431975Menzel J Piotrowski W Penzholz H: Long-term results of Gasserian ganglion electrocoagulation. J Neurosurg 42:140–143 1975

    • Search Google Scholar
    • Export Citation
  • 19.

    Mullan SLichtor T: Percutaneous microcompression of the trigeminal ganglion for trigeminal neuralgia. J Neurosurg 59:100710121983Mullan S Lichtor T: Percutaneous microcompression of the trigeminal ganglion for trigeminal neuralgia. J Neurosurg 59:1007–1012 1983

    • Search Google Scholar
    • Export Citation
  • 20.

    Nugent GR: Percutaneous techniques for trigeminal neuralgia in Kaye AHBlack P (eds): Operative Neurosurgery. London: Churchill Livingstone2000 pp 16151633Nugent GR: Percutaneous techniques for trigeminal neuralgia in Kaye AH Black P (eds): Operative Neurosurgery. London: Churchill Livingstone 2000 pp 1615–1633

    • Search Google Scholar
    • Export Citation
  • 21.

    Nugent GR: Surgical treatment: radiofrequency gangliolysis and rhizotomy in Fromm GHSessle BJ (eds): Trigeminal Neuralgia: Current Concepts Regarding Pathogenesis and Treatment. London: Butterworth-Heinemann1991 pp 159184Nugent GR: Surgical treatment: radiofrequency gangliolysis and rhizotomy in Fromm GH Sessle BJ (eds): Trigeminal Neuralgia: Current Concepts Regarding Pathogenesis and Treatment. London: Butterworth-Heinemann 1991 pp 159–184

    • Search Google Scholar
    • Export Citation
  • 22.

    Onofrio BM: Radiofrequency percutaneous Gasserian ganglion lesions. Results in 140 patients with trigeminal pain. J Neurosurg 42:1321391975Onofrio BM: Radiofrequency percutaneous Gasserian ganglion lesions. Results in 140 patients with trigeminal pain. J Neurosurg 42:132–139 1975

    • Search Google Scholar
    • Export Citation
  • 23.

    Peragut JCGondin-Oliveira JFabrizi Aet al: Micro-compression du ganglion de Gasser. Un traitment de la nevralgie faciale essentielle. A propos de 70 observations. Neurochirurgie 37:1111141991Peragut JC Gondin-Oliveira J Fabrizi A et al: Micro-compression du ganglion de Gasser. Un traitment de la nevralgie faciale essentielle. A propos de 70 observations. Neurochirurgie 37:111–114 1991

    • Search Google Scholar
    • Export Citation
  • 24.

    Rovit RL: Percutaneous radiofrequency thermal coagulation of the gasserian ganglion in Rovit RLMurali RJannetta PJ (eds): Trigeminal Neuralgia. Baltimore: Williams & Wilkins1990 pp 109136Rovit RL: Percutaneous radiofrequency thermal coagulation of the gasserian ganglion in Rovit RL Murali R Jannetta PJ (eds): Trigeminal Neuralgia. Baltimore: Williams & Wilkins 1990 pp 109–136

    • Search Google Scholar
    • Export Citation
  • 25.

    Saini SS: Reterogasserian anhydrous glycerol injection therapy in trigeminal neuralgia: observations in 552 patients. J Neurol Neurosurg Psychiatry 50:153615381987Saini SS: Reterogasserian anhydrous glycerol injection therapy in trigeminal neuralgia: observations in 552 patients. J Neurol Neurosurg Psychiatry 50:1536–1538 1987

    • Search Google Scholar
    • Export Citation
  • 26.

    Sweet WH: Complications of treating trigeminal neuralgia; an analysis of the literature and response to questionaire in Rovit RLMurali RJannetta PJ (eds): Trigeminal Neuralgia. Baltimore: Williams & Wilkins1990 pp 251279Sweet WH: Complications of treating trigeminal neuralgia; an analysis of the literature and response to questionaire in Rovit RL Murali R Jannetta PJ (eds): Trigeminal Neuralgia. Baltimore: Williams & Wilkins 1990 pp 251–279

    • Search Google Scholar
    • Export Citation
  • 27.

    Sweet WH: The treatment of trigeminal neuralgia (tic douloureux). N Engl J Med 315:1741771986Sweet WH: The treatment of trigeminal neuralgia (tic douloureux). N Engl J Med 315:174–177 1986

    • Search Google Scholar
    • Export Citation
  • 28.

    Taha JMTew JM Jr: Comparison of surgical treatments for trigeminal neuralgia: reevaluation of radiofrequency rhizotomy. Neurosurgery 38:8658711996Taha JM Tew JM Jr: Comparison of surgical treatments for trigeminal neuralgia: reevaluation of radiofrequency rhizotomy. Neurosurgery 38:865–871 1996

    • Search Google Scholar
    • Export Citation
  • 29.

    Waltz TADalessio DJCopeland Bet al: Percutaneous injection of glycerol for the treatment of trigeminal neuralgia. Clin J Pain 5:1951981989Waltz TA Dalessio DJ Copeland B et al: Percutaneous injection of glycerol for the treatment of trigeminal neuralgia. Clin J Pain 5:195–198 1989

    • Search Google Scholar
    • Export Citation
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