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The role of percutaneous balloon compression in the treatment of trigeminal neuralgia recurring after other surgical procedures

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Abstract

Trigeminal neuralgia (TN) recurring after surgery can be difficult to treat. Treatment algorithms have not been standardized or universally accepted. Here we investigated the effectiveness of percutaneous balloon compression (PBC) in the treatment of patients with TN recurrence after other surgical techniques and analyzed the role of some clinical and operative factors in determining the prognosis. The records of 22 patients (13 M and 9 F) suffering recurrent TN after one (2 gamma knife surgery, 5 percutaneous radiofrequency rhizotomy, 6 percutaneous retrogasserian glycerol rhizotomy, 3 microvascular decompression) or more (6 patients) procedures and submitted to PBC at our institution from January 2003 to February 2012 were reviewed. Seven patients had TN related to multiple sclerosis (MS). Mean follow-up was 51.81 ± 26.63 months. 81.81 % of patients reported an acute pain relief. No major complication was observed after PBC. Eight patients (36.36 %) experienced pain recurrence and underwent one (five patients) or more (three patients) PBC. At the last follow-up, we obtained an excellent outcome (BNI I–II) in 16 patients out of 22 (72.72 %) and a good outcome (BNI III) in the remaining six. No patients had an uncontrolled pain. The lack of history of MS (p = 0.0174), the pear-like shape of the balloon at the operation (p = 0.0234) and a compression time <5 min (p < 0.05) were associated to higher pain-free survival. Considering these results PBC could be considered a useful technique for patients whose pain recurs after other procedures.

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References

  1. Tatli M, Satici O, Kanpolat Y, Sindou M (2008) Various surgical modalities for trigeminal neuralgia: literature study of respective long-term outcomes. Acta Neurochir (Wien) 150:243–255

    Article  CAS  Google Scholar 

  2. Montano N, Papacci F, Cioni B, Di Bonaventura R, Meglio M (2013) What is the best treatment of drug-resistant trigeminal neuralgia in patients affected by multiple sclerosis? A literature analysis of surgical procedures. Clin Neurol Neurosurg 115:567–572

    Article  PubMed  Google Scholar 

  3. Montano N, Papacci F, Cioni B, Di Bonaventura R, Meglio M (2012) Percutaneous balloon compression for the treatment of trigeminal neuralgia in patients with multiple sclerosis. Analysis of the potentially prognostic factors. Acta Neurochir (Wien) 154:779–783

    Article  Google Scholar 

  4. Jellish WS, Benedict W, Owen K, Anderson D, Fluder E, Shea JF (2008) Perioperative and long-term operative outcomes after surgery for trigeminal neuralgia: microvascular decompression vs percutaneous balloon ablation. Head Face Med 2:4–11

    Google Scholar 

  5. Skirving DJ, Dan NG (2001) A 20-year review of percutaneous balloon compression of the trigeminal ganglion. J Neurosurg 94:913–917

    Article  CAS  PubMed  Google Scholar 

  6. Kouzounias K, Schechtmann G, Lind G, Winter J, Linderoth B (2010) Factors that influence outcome of percutaneous balloon compression in the treatment of trigeminal neuralgia. Neurosurgery 67:925–934

    Article  PubMed  Google Scholar 

  7. Omeis I, Smith D, Kim S, Murali R (2008) Percutaneous balloon compression for the treatment of recurrent trigeminal neuralgia: long-term outcome in 29 patients. Stereotact Funct Neurosurg 86:259–265

    Article  PubMed  Google Scholar 

  8. Bergenheim AT, Asplund P, Linderoth B (2013) Percutaneous retrogasserian balloon compression for trigeminal neuralgia: review of critical technical details and outcomes. World Neurosurg 79:359–368

    Article  PubMed  Google Scholar 

  9. Brown JA, Pilitsis JG (2005) Percutaneous balloon compression for the treatment of trigeminal neuralgia: results in 56 patients based on balloon compression pressure monitoring. Neurosurg Focus 18:E10

    Article  PubMed  Google Scholar 

  10. Campos WK, Linhares MN (2011) A prospective study of 39 patients with trigeminal neuralgia treated with percutaneous balloon compression. Arq Neuropsiquiatr 69:221–226

    Article  PubMed  Google Scholar 

  11. Chen JF, Tu PH, Lee ST (2011) Long-term follow-up of patients treated with percutaneous balloon compression for trigeminal neuralgia in Taiwan. World Neurosurg 76:586–591

    Article  PubMed  Google Scholar 

  12. Stomal-Słowińska M, Słowiński J, Lee TK, Uitti RJ, Deen HG, Reimer R, Cheshire WP Jr, Herzog-Bryan G, Wharen RE Jr (2011) Correlation of clinical findings and results of percutaneous balloon compression for patients with trigeminal neuralgia. Clin Neurol Neurosurg 113:14–21

    Article  PubMed  Google Scholar 

  13. Trojnik T, Ŝmigoc T (2012) Percutaneous trigeminal ganglion balloon compression rhizotomy: experience in 27 patients. Sci World J. doi:10.1100/2012/328936

    Google Scholar 

  14. Meglio M, Cioni B (1989) Percutaneous procedures for trigeminal neuralgia: microcompression versus radiofrequency thermocoagulation. Personal experience. Pain 38:9–16

    Article  CAS  PubMed  Google Scholar 

  15. Meglio M, Cioni B, Moles A, Visocchi M (1990) Microvascular decompression versus percutaneous procedures for typical trigeminal neuralgia: personal experience. Stereotact Funct Neurosurg 54–55:76–79

    Article  PubMed  Google Scholar 

  16. Ruge D, Brochner R, Davis L (1958) A study of the treatment of 637 patients with trigeminal neuralgia. J Neurosurg 15:528–536

    Article  CAS  PubMed  Google Scholar 

  17. Penman J (1968) Trigeminal neuralgia. In: Vinken PJ, Bruyn GW (eds) Handbook of clinical neurology, vol 5. North-Holland Publishing Company, Amsterdam, pp 296–322

    Google Scholar 

  18. Putzki N, Pfriem A, Limmroth V, Yaldizli O, Tettenborn B, Diener HC, Katsarava Z (2009) Prevalence of migraine, tension-type headache and trigeminal neuralgia in multiple sclerosis. Eur J Neurol 16:262–267

    Article  CAS  PubMed  Google Scholar 

  19. Mullan S, Duda EE, Patronas NJ (1980) Some examples of balloon technology in neurosurgery. J Neurosurg 52:321–329

    Article  CAS  PubMed  Google Scholar 

  20. Mullan S, Lichtor T (1983) Percutaneous microcompression of the trigeminal ganglion for trigeminal neuralgia. J Neurosurg 59:1007–1012

    Article  CAS  PubMed  Google Scholar 

  21. Park SS, Lee MK, Kim JW, Jung JY, Kim IS, Ghang CG (2008) Percutaneous balloon compression of trigeminal ganglion for the treatment of idiopathic trigeminal neuralgia: experience in 50 patients. J Korean Neurosurg Soc 43:186–189

    Article  PubMed Central  PubMed  Google Scholar 

  22. Zhang LW, Liu YG, Wu CY, Xu SJ, Zhu SG (2011) Radiofrequency thermocoagulation rhizotomy for recurrent trigeminal neuralgia after microvascular decompression. Chin Med J (Engl) 124:3726–3730

    Google Scholar 

  23. Amador N, Pollock BE (2008) Repeat posterior fossa exploration for patients with persistent or recurrent idiopathic trigeminal neuralgia. J Neurosurg 108:916–920

    Article  PubMed  Google Scholar 

  24. Pollock BE, Stein KJ (2010) Surgical management of trigeminal neuralgia patients with recurrent or persistent pain despite three or more prior operations. World Neurosurg 73:523–528

    Article  PubMed  Google Scholar 

  25. Kano H, Kondziolka D, Yang HC, Zorro O, Lobato-Polo J, Flannery TJ, Flickinger JC, Lunsford LD (2010) Outcome predictors after gamma knife radiosurgery for recurrent trigeminal neuralgia. Neurosurgery 67:1637–1644

    Article  PubMed  Google Scholar 

  26. Huang CF, Chiou SY, Wu MF, Tu HT, Liu WS (2010) Gamma knife surgery for recurrent or residual trigeminal neuralgia after a failed initial procedure. J Neurosurg 113(Suppl):172–177

    PubMed  Google Scholar 

  27. Park KJ, Kondziolka D, Berkowitz O, Kano H, Novotny J Jr, Niranjan A, Flickinger JC, Lunsford LD (2012) Repeat gamma knife radiosurgery for trigeminal neuralgia. Neurosurgery 70:295–305

    Article  PubMed  Google Scholar 

  28. Aubuchon AC, Chan MD, Lovato JF, Balamucki CJ, Ellis TL, Tatter SB, McMullen KP, Munley MT, Deguzman AF, Ekstrand KE, Bourland JD, Shaw EG (2011) Repeat gamma knife radiosurgery for trigeminal neuralgia. Int J Radiat Oncol Biol Phys 81:1059–1065

    Article  PubMed  Google Scholar 

  29. Hasegawa T, Kondziolka D, Spiro R, Flickinger JC, Lunsford LD (2002) Repeat radiosurgery for refractory trigeminal neuralgia. Neurosurgery 50:494–500

    PubMed  Google Scholar 

  30. Shetter AG, Rogers CL, Ponce F, Fiedler JA, Smith K, Speiser BL (2002) Gamma knife radiosurgery for recurrent trigeminal neuralgia. J Neurosurg 97(5 Suppl):536–538

    PubMed  Google Scholar 

  31. Gellner V, Kurschel S, Kreil W, Holl EM, Ofner-Kopeinig P, Unger F (2008) Recurrent trigeminal neuralgia: long term outcome of repeat gamma knife radiosurgery. J Neurol Neurosurg Psychiatry 79:1405–1407

    Article  CAS  PubMed  Google Scholar 

  32. Urgosik D, Liscak R, Novotny J Jr, Vymazal J, Vladyka V (2005) Treatment of essential trigeminal neuralgia with gamma knife surgery. J Neurosurg 102(Suppl):29–33

    Article  PubMed  Google Scholar 

  33. Regis J, Metellus P, Hayashi M, Roussel P, Donnet A, Bille-Turc F (2006) Prospective controlled trial of gamma knife surgery for essential trigeminal neuralgia. J Neurosurg 104:913–924

    Article  PubMed  Google Scholar 

  34. Park YS, Kim JP, Chang WS, Kim HY, Park YG, Chang JW (2011) Gamma knife radiosurgery for idiopathic trigeminal neuralgia as primary vs. secondary treatment option. Clin Neurol Neurosurg 113:447–452

    Article  PubMed  Google Scholar 

  35. Chen JF, Tu PH, Lee ST (2012) Repeated percutaneous balloon compression for recurrent trigeminal neuralgia: a long-term study. World Neurosurg 77:352–356

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Institute of Neurosurgery, Catholic University, Largo Agostino Gemelli, 8, 00168, Rome, Italy

    Nicola Montano, Fabio Papacci, Beatrice Cioni, Rina Di Bonaventura & Mario Meglio

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  1. Nicola Montano
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  2. Fabio Papacci
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  3. Beatrice Cioni
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  4. Rina Di Bonaventura
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  5. Mario Meglio
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Correspondence to Nicola Montano.

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Montano, N., Papacci, F., Cioni, B. et al. The role of percutaneous balloon compression in the treatment of trigeminal neuralgia recurring after other surgical procedures. Acta Neurol Belg 114, 59–64 (2014). https://doi.org/10.1007/s13760-013-0263-x

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  • DOI: https://doi.org/10.1007/s13760-013-0263-x

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